Systems and methods for facilitating a first response mission at an incident scene using patient monitoring

ABSTRACT

Systems and methods for facilitating a first response mission at an incident scene, such as an accident site, a natural or human-made disaster site, or any other first response site. One system comprises a portable patient module to be associated with a patient at the incident scene and configured to transmit wireless signals. The system also comprises a processing system comprising at least one receiver to receive the wireless signals and a processing entity configured to process data derived from the wireless signals to determine an action to be performed with respect to the patient, such as transmission of a message conveying information regarding the patient to a first responder at the incident scene, establishment of communication between a first responder at the incident scene and a clinician remote from the incident scene to discuss the patient, or transmission of a message to initiate preparation of resources at a healthcare facility remote from the incident scene for arrival of the patient.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application No. 60/992,182 filed on Dec. 4, 2007 by Graves et al. and hereby incorporated by reference herein.

FIELD OF THE INVENTION

The invention relates generally to first response services and, more particularly, to systems and methods for facilitating a first response mission at an incident scene.

BACKGROUND

First responders such as emergency medical service (EMS) workers, police officers or firefighters deployed at an incident scene have limited connectivity to hospitals and other places remote from the incident scene. In particular, first responders have limited connectivity to the emergency room (ER) of the hospital to which they are delivering and do not know the status of the ER, nor does the ER know their status. Adding to this the fact that only limited medical information, if any, can be passed backward and forward between the first responders and the hospital, the ER treatment typically starts with a patient assessment when the emergency vehicle arrives at the hospital, instead of being a continuous process from the moment when the first responders arrive at the incident scene.

Furthermore, the incident scene may encompass multiple casualties who have to be triaged and stabilized on-site if their number threatens to overwhelm the first responders. Those who are beyond hope and those who will survive without treatment take backstage to those where treatment makes a difference for survival.

In addition, the incident scene itself may be hazardous, both to the casualties and to the first responders. Unknown or undetected conditions or changes therein at the incident scene may present serious risks for both the casualties and the first responders.

While certain technologies have been developed to assist first responders, they are unsatisfactory in many respects. For example, existing technologies are typically point solutions and lack in terms of an integrated approach which takes into account information from a variety of sources. Also, existing technologies tend to not be rapidly deployable (i.e., seconds, not minutes or hours) and are thus often of limited effectiveness where time is crucial. Furthermore, while it may often be useful to know where the first responders and/or the casualties are located, existing technologies may only provide inadequate or insufficient precision in locating them (e.g., civilian grade global positioning system (GPS) technology typically offers accuracies of about 9 to 15 meters (30 to 50 feet), due to the user equivalent range errors (UEREs) of ionospheric effects, ephemeris errors, satellite clock errors, multipath distortion, and tropospheric effects).

Accordingly, there is a need for solutions facilitating a first response mission at an incident scene, and particularly for solutions providing first responders with bidirectional communication capability, real-time support for their information needs, and knowledge about their environment as they stabilize and transport patients under what may be hazardous conditions, solutions enabling the patients to be monitored, and solutions enabling precise location of the first responders and patients at the incident scene.

SUMMARY OF THE INVENTION

According to a first broad aspect, the invention provides a system for facilitating a first response mission at an incident scene. The system comprises a portable patient module to be associated with a patient at the incident scene and configured to transmit wireless signals. The system also comprises a processing system comprising at least one receiver to receive the wireless signals and a processing entity configured to process data derived from the wireless signals to determine an action to be performed with respect to the patient.

According to a second broad aspect, the invention provides a method for facilitating a first response mission at an incident scene. The method comprises: receiving wireless signals transmitted by a portable patient module associated with a patient at the incident scene; and processing data derived from the wireless signals to determine an action to be performed with respect to the patient.

According to a third broad aspect, the invention provides computer-readable media containing computer-readable program code executable by a computing apparatus to implement a process for facilitating a first response mission at an incident scene. The computer-readable program code comprises: first program code for causing the computing apparatus to be attentive to receipt of data derived from wireless signals transmitted by a portable patient module associated with a patient at the incident scene; and second program code for causing the computing apparatus to process the data derived from the wireless signals to determine an action to be performed with respect to the patient.

These and other aspects of the invention will now become apparent to those of ordinary skill in the art upon review of the following description of embodiments of the invention in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

A detailed description of embodiments of the invention is provided below, by way of example only, with reference to the accompanying drawings, in which:

FIG. 1 shows a first response support system for facilitating a first response mission at an incident scene, in accordance with an embodiment of the invention;

FIG. 2 shows a first responder pack of the first response support system, in accordance with an embodiment of the invention;

FIG. 3 shows a patient pack of the first response support system, in accordance with an embodiment of the invention;

FIG. 4 shows a drop pack of the first response support system, in accordance with an embodiment of the invention;

FIG. 5 shows a local processing station of the first response support system, in accordance with an embodiment of the invention;

FIG. 6 shows components of a healthcare facility that includes an environment- and context-aware system of the first response support system, in accordance with an embodiment of the invention;

FIG. 7A shows services that can be provided within the healthcare facility by the environment- and context-aware system, in accordance with an embodiment of the invention;

FIG. 7B shows services that can be provided in support of the first response mission by the environment- and context-aware system, in accordance with an embodiment of the invention;

FIG. 8 shows at a high level an environmental awareness component and a contextual awareness and response component of the environment- and context-aware system, in accordance with an embodiment of the invention;

FIGS. 9A to 9E show a cascaded location process to extend a location-awareness capability of the first response support system across the incident scene, in accordance with an embodiment of the invention; and

FIGS. 10A to 10D show an example of a geometry associated with a location determination process based on a differential time of arrival solution.

It is to be expressly understood that the description and drawings are only for the purpose of illustrating certain embodiments of the invention and are an aid for understanding. They are not intended to be a definition of the limits of the invention.

DETAILED DESCRIPTION OF EMBODIMENTS

FIG. 1 shows a first response support system 10 for facilitating a first response mission at an incident scene 12 (e.g., an accident site, a natural or human-made disaster site, or any other first response site), in accordance with an embodiment of the invention. In this case, the first response mission involves a plurality of first responders 14 ₁ . . . 14 _(N) arriving at the incident scene 12 via a plurality of first response vehicles 16 ₁ . . . 16 _(M) to perform various tasks at the incident scene 12, including providing first response aid to a plurality of patients 18 ₁ . . . 18 _(P) at the incident scene 12, potentially prior to transporting some or all of them to a healthcare facility 33, which may be a hospital or other healthcare establishment. Each of the patients 18 ₁ . . . 18 _(P) is an individual casualty at the incident scene 12 awaiting or receiving care and treatment, such as medical care and treatment, from one or more of the first responders 14 ₁ . . . 14 _(N) and/or awaiting transportation or being transported to the healthcare facility 33 or another healthcare facility. In this example, the first responders 14 ₁ . . . 14 _(N) are emergency medical service (EMS) workers (e.g., paramedics) and the first response vehicles 16 ₁ . . . 16 _(M) are ambulances, whereas in other examples the first responders 14 ₁ . . . 14 _(N) may include police officers, firefighters or other types of first responders and the first response vehicles 16 ₁ . . . 16 _(M) may include police vehicles, firefighter trucks or other types of emergency vehicles.

The first response support system 10 comprises a plurality of “packs” carried by the first responders 14 ₁ . . . 14 _(N) when arriving at the incident scene 12. Each of these packs is a portable electronic module that is embodied as a single portable device or combination of portable devices carried by a given one of the first responders 14 ₁ . . . 14 _(N) at the incident scene 12 (e.g., manually carried and/or worn by that first responder). More particularly, in this embodiment, these packs include a plurality of first responder packs 22 ₁ . . . 22 _(N) each personally kept by a respective one of the first responders 14 ₁ . . . 14 _(N) at the incident scene 12, a plurality of patient packs 24 ₁ . . . 24 _(P) each personally associated with a respective one of the patients 18 ₁ . . . 18 _(P), and a plurality of drop packs 26 ₁ . . . 26 _(R) which can be placed by the first responders 14 ₁ . . . 14 _(N) at various locations at the incident scene 12.

As further discussed later on, the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) are configured to transmit wireless signals from which can be derived various data regarding the incident scene 12, such as: location data indicative of a location of each of the first responders 14 ₁ . . . 14 _(N), the patients 18 ₁ . . . 18 _(P) and the drop packs 26 ₁ . . . 26 _(R) at the incident scene 12; physical data indicative of physical parameters (e.g., surrounding temperature, pressure, vibrations, chemical concentrations, radiation levels, etc.) sensed by these packs; physiological data indicative of physiological parameters (e.g., vital signs such as heart rate, blood pressure, body temperature, oxygenation level, breathing rate; toxin levels; etc.) of the patients 18 ₁ . . . 18 _(P); data derived from input made by the first responders 14 ₁ . . . 14 _(N) using their first responder packs 22 ₁ . . . 22 _(N); etc.

The first responder packs 22 ₁ . . . 22 _(N) also enable the first responders 14 ₁ . . . 14 _(N) to wirelessly communicate with one another and/or with remote clinicians (e.g., physicians, radiologists, pharmacists, interns, nurses, laboratory technicians or other individuals whose duties relate to patient diagnosis and/or treatment) and to wirelessly receive information relevant to their tasks (e.g., information regarding actions to be performed, such as administering certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility, moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to a different location, etc.).

In addition, the first response support system 10 comprises a processing system 20 to receive and process the wireless signals transmitted by the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) in order to determine actions to be taken with respect to the first response mission for optimizing communications involving the first responders 14 ₁ . . . 14 _(N) and increasing first responder effectiveness, quality of care to patients, patient/first responder safety, speed of processing and overall first response site safety. Examples of such actions include: administration of certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P); movement of one or more of the patients 18 ₁ . . . 18 _(P) and/or the first responders 14 ₁ . . . 14 _(N); communication of one or more of the first responders 14 ₁ . . . 14 _(N) with one or more doctors, nurses or other clinicians remote from the incident scene 12; transportation of one or more of the patients 18 ₁ . . . 18 _(P) to one or more healthcare facilities (e.g., transportation of different ones of the patients 18 ₁ . . . 18 _(P) to different healthcare facilities for load sharing between the different healthcare facilities); preparation of resources (e.g., equipment and clinicians) at one or more healthcare facilities for arrival of one or more of the patients 18 ₁ . . . 18 _(P); etc.

More particularly, in this embodiment, the processing system 20 comprises a remote processing subsystem 30 located remotely from the incident scene 12 and a plurality of local processing stations 28 ₁ . . . 28 _(M) transported to the incident scene 12 by respective ones of the first response vehicles 16 ₁ . . . 16 _(M). In this example, the remote processing subsystem 30 is located at a healthcare facility 33, which may be a hospital or other healthcare establishment. Each of the local processing stations 28 ₁ . . . 28 _(M) can communicate with the remote processing subsystem 30 via a wireless communication link 32, which may be established over an emergency services network and/or a communications provider network (e.g., a cellular, WiMax or other public or dedicated emergency services wireless network).

As further described later, in this embodiment, the remote processing subsystem 30 implements, and will hereinafter be referred to as, an “environment- and context-aware system” (ECAS) configured to determine which actions should be taken with respect to the first response mission when certain “situations” are deemed to occur, based on data derived from wireless signals transmitted by the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) at the incident scene 12. The ECAS 30 can be viewed as a smart (e.g., artificially intelligent) communication and information handling system which operates to achieve specific objectives set by applicable policies or guidelines/targets that it invokes on a basis of its deducing situations deemed to occur from its environmental and other contextual information sources and deductions. In regards to the first response mission considered in this example, the policies or guidelines/targets address optimization of communications involving the first responders 14 ₁ . . . 14 _(N) and increasing first responder effectiveness, quality of care to patients, patient/first responder safety, speed of processing and overall first response site safety.

For their part, the local processing stations 28 ₁ . . . 28 _(M) are transported to the incident scene 12 by respective ones of the first response vehicles 16 ₁ . . . 16 _(M) and provide communication, data processing and other functionality between the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS 30 (and other resources within the healthcare facility 33). In that sense, the local processing stations 28 ₁ . . . 28 _(M) will be referred to as “ECAS outstations”.

Generally speaking, the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R), the ECAS outstations 28 ₁ . . . 28 _(M) and the ECAS 30 can cooperate to provide information, communication and protective (against hazardous conditions) support to the first responder vehicles 16 ₁ . . . 16 _(M), the first responders 14 ₁ . . . 14 _(N) and the patients 18 ₁ . . . 18 _(P) at the incident scene 12 during first triage and treatment, stabilization and preparation for transport to bring the patients 18 ₁ . . . 18 _(P) into a clinical treatment system which, in this example, is centered at the healthcare facility 33 (and possibly one or more other healthcare facilities as may be involved).

The ECAS outstations 28 ₁ . . . 28 _(M) transported to the incident scene 12 and the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) deployed by the first responders 14 ₁ . . . 14 _(N) at the incident scene 12 enable capabilities of the ECAS 30 to be extended into a first response area at the incident scene 12. For example, some of the capabilities of the ECAS 30 that may be extended into the first response area include:

-   -   i. Precision location (absolute location or relative         location/proximity) for the first response vehicles 16 ₁ . . .         16 _(M), the first responders 14 ₁ . . . 14 _(N) and the         patients 18 ₁ . . . 18 _(P) at the incident scene 12;     -   ii. Automated monitoring of environmental conditions across the         incident scene 12 for purposes of detecting inclement, adverse         or potentially hazardous situations;     -   iii. An ability for the first responders 14 ₁ . . . 14 _(N) to         be clinically integrated into workflows and resources of the         healthcare facility 33, particularly its emergency room (ER),         during the stabilization and preparation for transport of the         patients 18 ₁ . . . 18 _(P) so that the healthcare facility's         staff and clinical resources and databases to which the ECAS 30         has access can provide support as needed to the first responders         14 ₁ . . . 14 _(N) and so that the healthcare facility 33 can be         provided with advance information on conditions of incoming ones         of the patients 18 ₁ . . . 18 _(P);     -   iv. An ability for the ECAS 30 and/or remote clinicians to         remotely track the locations of the patients 18 ₁ . . . 18 _(P)         and monitor the patients 18 ₁ . . . 18 _(P) (including         unattended ones) for key medical data and life sign         characteristics; and     -   v. Automatic association of the first responders 14 ₁ . . . 14         _(N) with different ones of the patients 18 ₁ . . . 18 _(P) that         they are treating or responsible for.

These and other capabilities of the ECAS 30 which can be extended into the first response area at the incident scene 12 can enhance the effectiveness, productivity and/or safety of the first responders 14 ₁ . . . 14 _(N) and the quality of care, speed of response and care, and/or safety of the patients 18 ₁ . . . 18 _(P).

The aforementioned components of the first response support system 10 will now be discussed in more detail.

Packs 22 ₁ . . . 24 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R)

The packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) communicate with the ECAS outstations 28 ₁ . . . 28 _(M) and the ECAS 30 of the processing system 20 to perform various functions, including: providing an accurate precision location capability across the incident scene 12, which allows the first responders 14 ₁ . . . 14 _(N) and the patients 18 ₁ . . . 18 _(P) to be tracked and associations to be established therebetween; providing location-aware sensor information about environmental conditions at the incident scene 12, which allows hazardous or adverse conditions to be detected; and facilitating communications, including communication between the first responders 14 ₁ . . . 14 _(N) and remote clinicians at the healthcare facility 33 as well as access to clinical information (which may be suitably profiled for first response use) from an institutional information system of the healthcare facility 33.

a) First Responder Packs 22 ₁ . . . 22 _(N)

FIG. 2 shows an embodiment of a first responder pack 22 _(j) of the first responder packs 22 ₁ . . . 22 _(N) that is kept by a first responder 14 _(j) of the first responders 14 ₁ . . . 14 _(N) at the incident scene 12. Other ones of the first responder packs 22 ₁ . . . 22 _(N) may be similarly constructed.

The first responder pack 22 _(j) comprises suitable hardware and software (which may include firmware) for implementing a plurality of functional components, including, in this embodiment, a location unit 40, an identification unit 46, a sensor unit 48, a wireless interface 42, a user interface 52, a communication unit 59, a processing entity 50 and a power supply 44. These functional components may be embodied as a single portable device or combination of portable devices carried by the first responder 14 _(j). For example, the single portable device or combination of portable devices constituting the first responder pack 22 _(j) may be manually carried by the first responder 14 _(j) and/or worn by the first responder 14 _(j) (e.g., strapped or otherwise attached on the first responder 14 _(j) or integrated with his/her clothing). The first responder pack 22 _(j) may be assigned to or associated with the first responder 14 _(j) before or upon arrival at the incident scene 12 by various means (e.g., by entering an identity of the first responder 14 _(j) and/or a password confirming this identity and/or by biometric association).

The location unit 40 enables the processing system 20 to determine a location of the first responder 14 _(j). To that end, the location unit 40 comprises a location transmitter (e.g., a location pinger) 41 to transmit a wireless location signal that allows the processing system 20 to determine the location of the first responder pack 22 _(j) and, thus, of the first responder 14 _(j). For example, the wireless location signal may be a short (e.g., nanosecond scale) radio frequency (RF) burst or series of short RF bursts. The processing system 20 can determine the location of the first responder 14 _(j) based on data derived from the wireless location signal, i.e., data conveyed by that signal and/or data generated upon reception of that signal such as data related to a time of arrival of that signal at a receiver having a known location. More particularly, in this embodiment, the processing system 20 determines the location of the first responder 14 _(j) based on three or more times of arrival of the wireless location signal at three or more location receivers (described later on) having known locations that are distributed among some of the ECAS outstations 28 ₁ . . . 28 _(M) and/or other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P). For instance, the processing system 20 may apply triangulation techniques (e.g., multilateration or trilateration) to determine the location of the first responder 14 _(j) based on the times of arrival of the wireless location signal at these three of more location receivers. Such triangulation techniques, which can be based on times of arrival either explicitly (i.e., on the times of arrival themselves) or implicitly (i.e., on differences between the times of arrival), are well known and need not be described here. In other embodiments, rather than allow the processing system 20 to effect location computations based on times of arrival of the wireless location signal transmitted by the location transmitter 41, the wireless location signal may convey other location data that indicates or can be used to compute the location of the first responder 14 _(j).

In addition, in this embodiment, once the first responder pack 22 _(j) has been located, the location unit 40 enables the processing system 20 to determine locations of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the first responder pack 22 _(j). To that end, the location unit 40 comprises a location receiver (e.g., a location sensor) 43 to receive wireless location signals from location transmitters of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the first responder pack 22 _(j). As further discussed later on, once it has been located by the processing system 20, the first responder pack 22 _(j) may transmit a wireless signal to the processing system 20 on a basis of the wireless locations signals it receives from these location transmitters in order to allow the processing system 20 to determine locations of those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) from which the first responder pack 22 _(j) received the wireless location signals.

Generally speaking, in this embodiment, and in accordance with a “cascaded location process” that is further discussed later on, the locations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) are determined in multiple stages by the processing system 20, whereby those packs whose locations are known are used to receive wireless location signals from other packs whose locations are unknown and transmit wireless signals to the processing system 20 on a basis of the wireless location signals that they receive in order to enable the locations of these other packs to be determined. This is particularly useful in that it allows the first response support system 10 to extend its location-awareness across the incident scene 12 by using packs which have been located in order to locate further packs that may be beyond the range of location receivers of the ECAS outstations 28 ₁ . . . 28 _(M).

In order for the cascaded location process to precisely locate the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), error propagation through the stages of the process should be minimized. To that end, the location unit 40 of each of the first responder packs 22 ₁ . . . 22 _(N), similar location units of the drop packs 26 ₁ . . . 26 _(R) and the patient packs 24 ₁ . . . 24 _(P) (described later on), and similar location units of the ECAS outstations 28 ₁ . . . 28 _(M) (also described later on), may employ wireless technology allowing a location of each of these components to be determined with an excessive level of precision, such as 1 m or better (e.g., 50 cm or even less), to permit a build-up of tolerances in a concatenated location approach to maintain an adequate final level of accuracy (e.g., this may be on the order of 1 m, for instance, to locate people, but may be much more precise, in some cases less than 30 cm, to allow automated associations between people or between people and equipment). For example, in this embodiment, the location units may employ ultra-wideband (UWB) technology (e.g., UWB tags) which offers increased precision, down to tens of centimeters or less (e.g., dependent upon “burst” envelope rise and fall times and receiver clock accuracy). In addition to permitting an expanded range of applications, such as associating a pack with a person near it, or two people together such as one of the first responders 14 ₁ . . . 14 _(N) and one of the patients 18 ₁ . . . 18 _(P), the increased precision of UWB technology helps to minimize error propagation through the stages of the cascaded location process (where positional errors can be cumulative in a complex but deterministic manner).

The identification unit 46 provides identification data serving to identify the first responder pack 22 _(j). The identification data may comprise one or more identifiers, such as an alphanumeric code (e.g., a UWB tag code, a serial number associated with the first responder pack 22 _(j), etc.). The wireless location signal transmitted by the location unit 40 of the first responder pack 22 _(j) may comprise the identification data (or data derived therefrom) to allow the processing system 20 to identify the first responder pack 22 _(j) it is locating. In this respect, while they are shown as separate components, it will be recognized that in some embodiments functionality of the identification unit 46 and the location unit 40 (and particularly its location transmitter 41) may be implemented by a common component (e.g., a UWB tag).

In some embodiments, the identification unit 46 may also provide data identifying the first responder 14 _(j) to allow the processing system 20 to identify the first responder 14 _(j) associated with the first responder pack 22 _(j). For example, the identification unit 46 may store an identifier such as name of the first responder 14 _(j). The identifier, which may be provided in the identification unit 46 in various ways such as by coding at issue to the first responder 14 _(j) or by a process of identification and authentication while in transit to or at arrival at to the incident scene 12 (e.g., a fingerprint scan or entry of the identifier and possibly a password using the user interface 52), can be used to identify the first responder 14 _(j) to the ECAS 30 both for first responder/patient association and for ECAS-enabled access to clinical services and communications (e.g., allowing remote clinicians at the healthcare facility 33 to know which first responder, which patient—by proximity—and any collected data so they can provide better support). In cases where the identification unit 46 does not provide data explicitly identifying the first responder 14 _(j), the processing system 20 may already store an association between the identification data provided by the identification unit 46 and an identity of the first responder 14 _(j) (e.g., further to a provisioning phase where the first responder pack 22 _(j) was assigned to the first responder 14 _(j)).

The sensor unit 48 enables the processing system 20 to understand physical conditions of the incident scene 12 around the first responder 14 _(j). This allows detection of various inclement, adverse or hazardous conditions which the first responder 14 _(j) (and possibly one or more patients he/she may be handling) may face and alerting the first responder 14 _(j) when such conditions are detected (e.g., notifying the first responder 14 _(j) to evacuate its current location, either directly when a predetermined threshold is exceeded or in response to a message received from the ECAS 30), thereby improving his/her safety (and that of the one or more patients he/she may be handling).

More particularly, the sensor unit 48 comprises one or more physical sensors for sensing one or more physical parameters (e.g., temperature, pressure, chemical concentration, electromagnetic radiation level such as light intensity or hard radiation level, vibration level, etc.) and/or other physical activity (e.g., motion of a person or object) around the first responder pack 22 _(j) and for generating physical data indicative of these one or more physical parameters and/or other physical activity. For example, the sensor unit 48 may comprise one or more of: temperature/heat sensors (e.g., to detect surrounding temperature); pressure sensors (e.g., to detect atmospheric pressure); chemical sensors (e.g., to sense concentrations or traces of chemicals, such as explosive substances); mass/weight sensors (e.g., to sense mass/weight of persons or objects); vibration sensors (e.g., to sense ground vibrations); movement sensors (e.g., to sense movement of persons or objects); sound sensors (e.g., to sense voices, mechanical sounds, sounds from movement); visible light sensors (e.g., to sense visible light intensity); infrared light sensors (e.g., to sense infrared light emitted by persons or objects or effect video surveillance); RF sensors (e.g., to sense RF emissions or interference); hard radiation sensors (e.g., to sense x-rays, gamma rays or other hard radiation to effect Geiger counter/detection of nuclear decay, hidden object sensing); biotoxin sensors (e.g., to sense airborne or surface toxins, bacteria or viruses); cameras (e.g., to detect movement or identify person or objects, for instance, to effect video surveillance or provide imagery of a nearby patient to remote clinicians at the healthcare facility 33); liquid sensors (e.g., to sense presence of water or other liquids); and gas/vapor sensors (e.g., to sense presence of hazardous or harmful gases such as H₂S, CO, methane or propane, and/or hazardous or harmful vapors or gases such as chlorine, fluorine, bromine or petroleum vapors; to sense inadequate levels of oxygen, or presence of smoke or combustion products; etc). These examples are presented for illustrative purposes only as the sensor unit 48 may comprise sensors with various other sensing capabilities.

In addition to its location and sensing functions, the first responder pack 22 _(j) can serve as a remote field-located communications terminal linked to the ECAS 30 and other resources of the healthcare facility 33, enabling the first responder 14 _(j) to be treated as a clinician with a specific set of services and access rights, as appropriate to first responders and adapted by the ECAS 30 understanding the first responder's context.

More specifically, the user interface 52 enables the first responder 14 _(j) to exchange information with the ECAS 30. It comprises a display and possibly one or more other output elements (e.g., a speaker, etc.) enabling the first responder pack 22 _(j) to present information to the first responder 14 _(j), as well as one or more input elements (e.g., a keyboard, a microphone, a pointing device, a touch sensitive surface, a stylus perhaps built into a glove finger, etc.) enabling the first responder 14 _(j) to input information into the first responder pack 22 _(j). These input and output elements of the user interface 52 may be adapted for rough and hostile outside conditions and/or various levels of illumination from direct sunlight to near-darkness in which the first responder 14 _(j) may evolve at the incident scene 12, and be able to be operated by the first responder 14 _(j) when in appropriate protective clothing (e.g., a heavy coat and gloves in winter conditions).

Various exchanges of information may take place between the first responder 14 _(j) and the ECAS 30 using the user interface 52. For example, the first responder 14 _(j) may: pull up any available information from an electronic healthcare record, such as an electronic health record (EHR), electronic patient record (EPR) or electronic medical record (EMR), of a patient he/she is treating should it exist and should the patient have been identified; open up and populate a medical data file with information about the patient, such as personal information, his/her condition and/or what has been done to the him/her by the first responder 14 _(j), by a semi-automated process (which may involve the patient's patient back as discussed below), the medical data file being integrated into the patient's EHR, EPR or EMR if it can be cross-referenced thereto or being delivered as a stand-alone record; use decision information support tools (DIST) or other applications implemented by the ECAS 30; and/or receive information regarding actions to be performed, such as administering certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility, moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to a different location, etc, based on determinations made by the ECAS 30. In this respect, the first responder pack 22 _(j) may interact with the ECAS 30 to identify and authenticate the first responder 14 _(j) and to provide him/her with a broad range of services and capabilities based upon his/her authorization profile, but adapted by the ECAS's computed current situational and institutional context surrounding the first responder 14 _(j).

The communication unit 59 is configured to enable the first responder 14 _(j) to wirelessly communicate with other parties, such as other ones of the first responders 14 ₁ . . . 14 _(N), individuals remote from the incident scene 12 such as doctors or other clinicians at the healthcare facility, and/or automated speech, text and/or image processing systems. In particular, the communication unit 59 enables the first responder 14 _(j) to communicate with clinicians at the healthcare facility 33, especially those in its receiving ER, both to allow these clinicians to assist in stabilizing a patient treated by the first responder 14 _(j) and to allow these clinicians to better prepare to receive that patient. To achieve its function, the communication unit 59 comprises a microphone and possibly other input elements (e.g., a keypad, touch sensitive surface) as well as a speaker and possibly other output elements (e.g., a display) to allow the first responder 14 _(j) to communicate. The communication unit 59 also comprises a transmitter and a receiver to send and receive wireless signals establishing communications involving the first responder 14 _(j). In some embodiments, the communication unit 59 may be integrated with one or more other devices of the first responder pack 22 _(j), in particular, it may be implemented by the processing entity 50, the wireless interface 42 and the user interface 52. In other embodiments, the communication unit 59 may be implemented as a communication device (e.g., a mobile phone, including a wireless-enabled personal digital assistant (PDA)) which may be separate from the user interface 52 and the wireless interface 42 of the first responder pack 22 _(j) and which may linked to an emergency wireless network or a service provider wireless network.

The wireless interface 42 provides a bidirectional communication capability to connect the first responder pack 22 _(j) to the ECAS outstations 28 ₁ . . . 28 _(M) (e.g., to report location and sensor information) and, in embodiments where it is used to implement the communication unit 59, to provide a bidirectional communication channel for the first responder 14 _(j). More particularly, the wireless interface 42 comprises a wireless transmitter to transmit wireless signals destined for one or more of the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data generated by the first responder pack 22 _(j), such as data derived from a wireless location signal received by its location receiver 43 (e.g., data related to a time of arrival of that signal), data generated by its sensor unit 48 and/or data derived from input made by the first responder 14 _(j) via the user interface 52. Also, the wireless interface 42 comprises a wireless receiver to receive wireless signals from one or more of the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data destined for the first responder pack 22 _(j), such as data representing information to be presented to the first responder 14 _(j) via the user interface 52 (e.g., information regarding actions to be performed, such as administering certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility, moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to a different location, etc.) and/or data indicative of commands to be executed by the first responder pack 22 _(j) (e.g., commands to activate/deactivate the location receiver 43 and/or one or more sensors of the sensor unit 48).

The processing entity 50 performs various processing operations to implement functionality of the first responder pack 22 _(j). For example, these processing operations may include operations to: process data generated by the sensor unit 48, data derived from a wireless location signal received by the location receiver 43 (e.g., data related to a time of arrival of that signal), and data derived from input made by the first responder 14 _(j) via the user interface 52; activate/deactivate components of the first responder pack 22 _(j) (e.g., the location receiver 43 and/or one or more sensors of the sensor unit 48); cause the wireless interface 42 to transmit a wireless signal conveying data derived from a wireless location signal received by the location receiver 43 (e.g., data related to a time of arrival of that signal), data generated by the sensor unit 48 and/or data derived from input made by the first responder 14 _(j) via the user interface 52; cause the user interface 52 to present (e.g., display) to the first responder 14 _(j) information derived from a wireless signal received via the wireless interface 42; etc.

The processing operations may also implement a timing and synchronization function to ensure that the location transmitter 41 transmits wireless location signals at precise instants and that times of arrival of wireless locations signals at the location receiver 43 are accurately measured. This measurement may be made based on an absolute timing reference that can be distributed amongst the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS outstations 28 ₁ . . . 28 _(M). Alternatively, the measurement may be made relative to a local timing of the location transmitter 41, in which case a “relative” time of reception at the location receiver 43 of a wireless location signal transmitted by an unlocated one of the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) can be captured and forwarded to the processing system 20. Since it knows the times of reception of wireless location signals transmitted by the location transmitter 41 and has computed the location of that transmitter, the processing system 20 can compute the distance to and hence time of flight from the location receiver 43 and thus can determine, from the measured and reported relative time, the actual time of arrival at the location receiver 43 of the wireless location signal transmitted by the unlocated pack. (For example, considering a case in which the pack 14 22 _(j) is 114 ft away from the ECAS outstation 28 _(k) and receives a wireless location signal from a further away unlocated pack, say pack X, at 85 ns before its own wireless location signal is transmitted and passes this data on to the ECAS outstation 28 _(k), the ECAS outstation 28 _(k) may look at the timing of the located pack's signals (say an arbitrary 405 ns reference its own time datum) and subtract the time of flight of 114 ns from that to determine that the pack 22 _(j) transmitted at 291 ns and subtract 85 ns from that to determine that the unlocated pack's signal was received at the located pack 22 _(j) at 206 ns. If this is compared with the results from two other located packs, say packs B and C, for instance, yielding results of 222 ns and 175 ns then the differential differences are pack B—pack 22 _(j)=222−206=16 ns, pack B—pack C=222−175=47 ns and pack 22 _(j)—pack C=206−175=31 ns, placing the unlocated pack X at 16 ft further from pack B than pack 22 _(j), 47 ft further from pack B than pack C and 31 ft further from pack C than pack B. Knowing the locations of the packs 22 _(j), B, C, the processing system 20 can “draw” the lines of location which meet the criterion of being 16 ft further from pack B than the pack 22 _(j), another set of lines of location which meet the criterion of being 47 ft further from pack B than pack C and yet another set of lines which meet the criterion of being 31 ft further from pack A than pack C. These lines intersect at only one point, which corresponds to the location of the unlocated pack.)

The processing entity 50 comprises one or more processors to perform its various processing operations. A given one of these one or more processors may be a general-purpose processor having access to a storage medium (e.g., semiconductor memory, including one or more ROM and/or RAM memory devices) storing program code for execution by that processor to implement the relevant processing operations. Alternatively, a given one of these one or more processors may be a specific-purpose processor comprising one or more pre-programmed hardware or firmware elements (e.g., application-specific integrated circuits (ASICs), electrically erasable programmable read-only memories (EEPROMs), etc.) or other related elements to implement the relevant processing operations.

The power supply 44 comprises one or more batteries and/or other power storage elements to supply power to the various components of the first responder pack 22 _(j). The power supply 44 has a power capacity enabling the first responder pack 22 _(j) to be used as long as possible for purposes of the first response mission at the incident scene 12 (e.g., about sixteen hours to handle cases where the first responder 14 _(j) works a double shift). The power supply 44 may also have charging circuitry to facilitate its recharging. The power supply 44 may also provide power by other means. For example, it may comprise powering elements to provide power based on solar or vibrational energy, which can be used to supplement its primary energy source.

While in this embodiment the first responder pack 22 _(j) comprises various components, in other embodiments, it may not comprise all of these components and/or may comprise different components.

b) Patient Packs 24 ₁ . . . 24 _(P)

FIG. 3 shows an embodiment of a patient pack 24 _(j) of the patient packs 24 ₁ . . . 24 _(P) that is personally associated with a patient 18 _(j) of the patients 18 ₁ . . . 18 _(P) at the incident scene 12. Other ones of the patient packs 24 ₁ . . . 24 _(P) may be similarly constructed.

The patient pack 24 _(j) comprises suitable hardware and software (which may include firmware) for implementing a plurality of functional components, including, in this embodiment, a location unit 140, an identification unit 146, a sensor unit 148, a wireless interface 142, a processing entity 150 and a power supply 144. These functional components may be embodied as a single portable device or combination of portable devices carried by a first responder 14 _(k) of the first responders 14 ₁ . . . 14 _(N) at the incident scene 12 until he/she reaches the patient 18 _(j) and associates the single portable device or combination of portable devices with the patient 18 _(j). For example, the single portable device or combination of portable devices constituting the patient pack 18 _(j) may be strapped or otherwise fixed to the patient 18 _(j) and/or may be placed adjacent to the patient 18 _(j) (e.g., in cases where the patient 18 _(j) is expected to remain immobile, for instance, due to injury) by the first responder 14 _(k).

The location unit 140 enables the processing system 20 to determine a location of the patient 18 _(j). To that end, the location unit 140 comprises a location transmitter (e.g., pinger) 141 to transmit a wireless location signal that allows the processing system 20 to determine the location of the patient pack 24 _(j) and, thus, of the patient 18 _(j). For example, the wireless location signal may be a short RF burst or series of short RF bursts. More particularly, in this embodiment, the processing system 20 determines the location of the patient 18 _(j) based on three or more times of arrival of the wireless location signal at three of more location receivers having known locations that are distributed among some of the ECAS outstations 28 ₁ . . . 28 _(M) and/or other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) using triangulation techniques. In other embodiments, rather than allow the processing system 20 to effect location computations based on times of arrival of the wireless location signal transmitted by the location transmitter 141, the wireless location signal may convey other location data that indicates or can be used to compute the location of the patient 18 _(j).

In addition, in this embodiment, once the patient pack 24 _(j) has been located, the location unit 140 enables the processing system 20 to determine locations of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the patient pack 24 _(j). To that end, the location unit 140 comprises a location receiver (e.g., a location sensor) 143 to receive wireless location signals from location transmitters of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the patient pack 24 _(j). As part of the aforementioned cascaded location process (which is further discussed later on), once it has been located by the processing system 20, the patient pack 24 _(j) may transmit a wireless signal to the processing system 20 on a basis of the wireless location signals it receives from these location transmitters in order to allow the processing system 20 to determine locations of those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) from which it received the wireless location signals. As mentioned above, in order to minimize error propagation through the stages of the cascaded location process, the location unit 140 may employ wireless technology allowing a location of those packs within its range to be determined with an excessive level of precision, such as 1 m or better (e.g., 50 cm or even less), to permit a build-up of tolerances in a concatenated location approach to maintain an adequate final level of accuracy. For example, in this embodiment, the location unit 140 may employ UWB technology (e.g., a UWB tag) which offers increased accuracy, down to tens of centimeters or less.

The identification unit 146 provides identification data serving to identify the patient pack 24 _(j). The identification data may comprise one or more identifiers, such as an alphanumeric code (e.g., a UWB tag code, a serial number associated with the patient pack 24 _(j), etc.). The wireless location signal transmitted by the location unit 140 of the patient pack 24 _(j) may comprise the identification data (or data derived therefrom) to allow the processing system 20 to identify the patient pack 24 _(j) it is locating. In this respect, while they are shown as separate components, it will be recognized that in some embodiments functionality of the identification unit 146 and the location unit 140 (and particularly its location transmitter 141) may be implemented by a common component (e.g., a UWB tag).

In some embodiments, the identification unit 146 may also store data identifying the patient 18 _(j) and/or data indicative of his/her status (e.g., his/her condition and/or priority/treatment) to allow the processing system 20 to identify the patient 18 _(j) associated with the patient pack 24 _(j) and/or know his/her status. For example, the identification unit 146 may store a name and/or healthcare card registration number of the patient 18 _(j) and/or a triage code (e.g., a triage color code) assigned to the patient 18 _(j). This information may initially be input into the identification unit 146 by the first responder 14 _(k) who associates the patient pack 24 _(j) with the patient 18 _(j). For example, in some cases, the patient pack 24 _(j) may comprise a user interface (not shown) comprising a display and possibly one or more other output elements (e.g., a speaker, etc.) and one or more input elements (e.g., a keyboard, a microphone, a pointing device, a touch sensitive surface, a stylus, etc.) to enable the first responder 14 _(k) to enter the patient's name (and/or other identifier) and/or the triage code into the identification unit 146. As an alternative, the first responder 14 _(k) may activate a predetermined identifier for the patient pack 24 _(j), which becomes the identifier associated with data regarding the patient 18 _(j) (e.g., patient clinical and non-clinical data) until a patient identity is made/added, either at activation or at a subsequent time. In other cases, the first responder 14 _(k) may use the user interface 52 of his/her first responder pack 22 _(k) to enter the patient's name and/or the triage code into the identification unit 146 of the patient pack 24 _(j). For instance, each of the first responder pack 22 _(k) and the patient pack 24 _(j) may comprise a short-range data exchange interface (e.g., an infrared data exchange interface) via which the patient's name and/or the triage code entered into the first responder pack 22 _(k) by the first responder 14 _(k) may be transferred to the identification unit 146 of the patient pack 24 _(j). Alternatively, upon establishment of a proximate state between the patient pack 24 _(j) and first responder pack 22 _(k), the processing system 20 may create an association between the first responder 14 _(k) and the patient 18 _(j) and, as soon as the first responder 14 _(k) captures an identity for the patient (e.g. “Mr. John Smith III of 17 Crestview Drive, Richmond”, patient with health card registration # 023-6043-507321, or just unknown casualty #17) using his/her first responder pack 22 _(k), this identity is added to the association and from there is downloaded into the patient pack 24 _(j) via a given one of the ECAS outstation 28 ₁ . . . 28 _(M) and the wireless interface 142.

Alternatively or additionally, in some embodiments, the first responder 14 _(k) may place an ID bracelet on the patient 18 _(j) and use this ID bracelet to provide information identifying the patient 18 _(j) to the processing system 20. The ID bracelet may have a readable identifier (e.g., a barcode, an alphanumeric code, etc.) which the first responder 14 _(k) may associate with the identification data stored in the identification unit 146 of the patient pack 24 _(j) in order to allow the processing system 20 to identify the patient 18 _(j) associated with the patient pack 24 _(j).

For example, in one embodiment, the readable identifier of the ID bracelet may be a machine-readable identifier (e.g., a barcode), the patient pack 24 _(j) may be provided with a machine-readable identifier conveying part or all of the identification data stored in the identification unit 146 (e.g., a UWB tag code), and the first responder pack 22 _(k) may comprise a suitable reader (e.g., a barcode reader) to read each of these two identifiers. Upon using this reader to read the two identifiers, the first responder 14 _(k) may use the user interface 52 of the first responder pack 22 _(k) to enter the patient's name and triage code and/or other status data. In order to expedite this data entry process, the processing entity 50 of the first responder pack 22 _(k) may implement a data entry application including a database of common first and last names and/or a list of triage codes and/or other codes indicative of frequent medical condition or necessities (e.g., “immobilize patient before transportation”, for instance, in case of a severe neck injury), whereby the first responder 14 _(k) can rapidly enter the patient's name by entering starting letters and selecting from a list of candidate names from the database and/or can quickly select a desired triage code or other relevant code from the list of codes. Once this information is entered, the first responder pack 22 _(k) may transmit a wireless signal conveying the identifier read from the ID bracelet and the identifier read from the patient pack 24 _(j), as well as the patient's name and/or the triage or other code, to the processing system 20 via its wireless interface 42 in order to allow the processing system 20 to identify the patient 18 _(j) associated with the patient pack 24 _(j) and know his/her status.

As another example, in one embodiment, the readable identifier of the ID bracelet may be a human-readable identifier (e.g., an alphanumeric code) and the patient pack 24 _(j) may be provided with a human-readable identifier conveying part or all of the identification data stored in the identification unit 146 (e.g., a UWB tag code or a code associated therewith in the processing system 20). In this case, the first responder 14 _(k) may use the user interface 52 of his/her first responder pack 22 _(k) to enter each of these two identifiers as well as the patient's name and triage code or other status data, and, once this information is entered, the first responder pack 22 _(k) may transmit a wireless signal conveying this information to the processing system 20 via its wireless interface 42 in order to allow the processing system 20 to identify the patient 18 _(j) associated with the patient pack 24 _(j).

In other examples, the processing system 20 may identify the patient 18 _(j) associated with the patient pack 24 _(j) in various other ways, based on an association between the readable identifier of the ID bracelet and the identification data stored in the identification unit 24 of the patient pack 24 _(j). Also, in other examples, other types of wearable identification elements (e.g., badges, stickers, etc.) having a readable identifier may be placed on the patient 18 _(j) instead of an ID bracelet.

In view of the foregoing, when the first responder 14 _(k) associates the patient pack 24 _(j) with the patient 18 _(j), the processing system 20 detects proximity of the first responder 14 _(k) to the patient 18 _(j) and, based on this proximity, proceeds to create an association between the first responder 14 _(k) and the patient 18 _(j). In cases where the first responder 14 _(k) ascertained the identity of the patient 18 _(j), the first responder 14 _(k) may be able to access any pre-existing EHR, EMR or EPR information for the patient 18 _(j), suitably filtered for first response use, using his/her first responder pack 22 _(k) and the healthcare facility 33 may be able to better prepare for receiving the patient 18 _(j) since it can both track the patient's context, status and progress as he/she is handled coming out of the incident scene en route to its ER. The first responder 14 _(k) and/or remote clinicians at the healthcare facility 33 can thus be made aware (from the patient EHR as well as field data) of pre-existing special circumstances surrounding the patient 18 _(j). For example, if the patient 18 _(j) is comatose from his/her injuries and may also be diabetic, his/her blood sugar may be monitored closely. As another example, if the patient 18 _(j) is known to have a pre-existing heart condition and has a crushed left leg resulting from events at the incident scene 12, he/she has an increased chance of dying due to stress-induced heart failure and so must be treated differently than a healthy person with the same injury. In cases where the patient 18 _(j) cannot readily be medically identified and associated with medical records, he/she may still be allocated a unique but arbitrary identifier to track their progress and treatment until they arrive at the healthcare facility 33.

The sensor unit 148 enables the processing system 20 to understand physical conditions of the incident scene 12 around the patient 14 _(j), allowing detection of various inclement, adverse or hazardous conditions surrounding the patient 14 _(j), thereby improving his/her safety. In addition, the sensor unit 148 enables monitoring of a medical condition of the patient 14 _(j) that is reported to the ECAS 30. This allows the ECAS 30 to continuously monitor the patient 14 _(j) at the incident scene 12, even if no first responder can be with him/her (e.g., in cases where there are more casualties than first responders). This can also allow the ECAS 30, which may have access to EHR, EMR or EPR information of the patient 14 _(j), to detect potential flag-able impairments based on the patient's condition, and signal same back to the first responder 14 _(k). To that end, the sensor unit 148 comprises a physical sensor part 147 and a medical sensor part 149.

The physical sensor part 147 comprises one or more physical sensors for sensing one or more physical parameters (e.g., temperature, pressure, chemical concentration, electromagnetic radiation level such as light intensity or hard radiation level, vibration level, etc.) and/or other physical activity (e.g., motion of a person or object) around the patient pack 24 _(j) and for generating data indicative of these one or more physical parameters and/or other physical activity. For example, the sensor unit 148 may comprise one or more of: temperature/heat sensors (e.g., to detect surrounding temperature); pressure sensors (e.g., to detect atmospheric pressure); chemical sensors (e.g., to sense concentrations or traces of chemicals, such as explosive substances); mass/weight sensors (e.g., to sense mass/weight of persons or objects); vibration sensors (e.g., to sense ground vibrations); movement sensors (e.g., to sense movement of persons or objects); sound sensors (e.g., to sense voices, mechanical sounds, sounds from movement); visible light sensors (e.g., to sense visible light intensity) infrared light sensors (e.g., to sense infrared light emitted by persons or objects or effect video surveillance); RF sensors (e.g., to sense RF emissions or interference); hard radiation sensors (e.g., to sense x-rays, gamma rays or other hard radiation to effect Geiger counter/detection of nuclear decay, hidden object sensing); biotoxin sensors (e.g., to sense airborne or surface toxins, bacteria or viruses); cameras (e.g., to detect movement or identify person or objects, for instance, to effect video surveillance or provide imagery of the patient 18 _(j) to remote clinicians at the healthcare facility 33); liquid sensors (e.g., to sense presence of water or other liquids); and gas/vapor sensors (e.g., to sense presence of hazardous or harmful gases such as H₂S, CO, methane or propane, and/or hazardous or harmful vapors or gases such as chlorine, fluorine, bromine or petroleum vapors; to sense inadequate levels of oxygen, or presence of smoke or combustion products; etc). These examples are presented for illustrative purposes only as the physical sensor part 147 may comprise sensors with various other sensing capabilities.

The medical sensor part 149 comprises one or more physiological sensors for sensing one or more physiological parameters of the patient 18 _(j) and for generating data indicative of these one or more physiological parameters. For example, the sensor unit 148 may comprise one or more sensors for sensing a heart rate, blood pressure, body temperature, oxygenation level, breathing rate, or toxin level of the patient 18 _(j), or for sensing any other physiological parameter relevant to evaluating the patient's medical condition (in that sense, the physiological parameters sensed by the medical sensor part 149 can also be referred to as “medical parameters”). Each physiological sensor of the medical sensor part 149 may be strapped (e.g., to a wrist) or otherwise externally fixed on the patient's body and/or may be partially or entirely inserted into the patient's body (e.g., intradermally, intravenously). For instance, in some embodiments, various physiological sensors of the medical sensor part 149 may be included in a wrist bracelet 39 worn by the patient 18 _(j) (which can also serve as an ID bracelet) and a patient monitor 37 wired to the patient 18 _(j), both wirelessly connected (e.g., via a Bluetooth® or equivalent short-range wireless link) to a wireless receiver of the medical sensor part 149.

The wireless interface 142 provides a bidirectional communication capability to connect the patient pack 24 _(j) to the ECAS outstations 28 ₁ . . . 28 _(M) (e.g., to report location and sensor information). More particularly, the wireless interface 142 comprises a wireless transmitter to transmit wireless signals destined for one or more of the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data generated by the patient pack 24 _(j), such as data derived from a wireless location signal received by its location receiver 143 (e.g., data related to a time of arrival of that signal) and/or data generated by its sensor unit 148. Also, the wireless interface 142 comprises a wireless receiver to receive wireless signals from one or more of the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data destined for the patient pack 24 _(j), such as data indicative of commands to be executed by the patient pack 24 _(j) (e.g., commands to activate/deactivate the location receiver 143 and/or one or more sensors of the sensor unit 148).

The processing entity 150 performs various processing operations to implement functionality of the patient pack 24 _(j). For example, these processing operations may include operations to: process data generated by the sensor unit 148 and data derived from a wireless location signal received by the location receiver 143 (e.g., data related to a time of arrival of that signal); activate/deactivate components of the patient pack 24 _(j) (e.g., the location receiver 143 and/or one or more sensors of the sensor unit 148); cause the wireless interface 142 to transmit a wireless signal conveying data generated by the sensor unit 148 and/or data derived from a wireless location signal received by the location receiver 143 (e.g., data related to a time of arrival of that signal); etc.

The processing operations may also implement a timing and synchronization function to ensure that the location transmitter 141 transmits wireless location signals at precise instants and that times of arrival of wireless locations signals at the location receiver 143 are accurately measured. This measurement may be made based on an absolute timing reference that can be distributed amongst the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS outstations 28 ₁ . . . 28 _(M). Alternatively, the measurement may be made relative to a local timing of the location transmitter 141, in which case a “relative” time of reception at the location receiver 143 of a wireless location signal transmitted by an unlocated one of the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) can be captured and forwarded to the processing system 20. Since it knows the times of reception of wireless location signals transmitted by the location transmitter 141 and has computed the location of that transmitter, the processing system 20 can compute the distance to and hence time of flight from the location receiver 143 and thus can determine, from the measured and reported relative time, the actual time of arrival at the location receiver 143 of the wireless location signal transmitted by the unlocated pack.

The processing entity 150 comprises one or more processors to perform its various processing operations. A given one of these one or more processors may be a general-purpose processor having access to a storage medium (e.g., semiconductor memory, including one or more ROM and/or RAM memory devices) storing program code for execution by that processor to implement the relevant processing operations. Alternatively, a given one of these one or more processors may be a specific-purpose processor comprising one or more pre-programmed hardware or firmware elements (e.g., ASICs, EEPROMs, etc.) or other related elements to implement the relevant processing operations.

The power supply 144 comprises one or more batteries and/or other power storage elements to supply power to the various components of the patient pack 24 _(j). The power supply 144 has a power capacity enabling the patient pack 24 _(j) to be used as long as possible for purposes of the first response mission at the incident scene 12 (e.g., a few hours to allow sufficient time to provide proper treatment to the patient 18 _(j) and/or transport him/her to the healthcare facility 33). The power supply 144 may also have charging circuitry to facilitate its recharging. The power supply 144 may also provide power by other means. For example, it may comprise powering elements to provide power based on solar or vibrational energy, which can be used to supplement its primary energy source.

While in this embodiment the patient pack 24 _(j) comprises various components, in other embodiments, it may not comprise all of these components and/or may comprise different components. For example, in some embodiments, the patient pack 24 _(j) may comprise a communication unit enabling the patient 18 _(j) to wirelessly communicate with the first responders 14 ₁ . . . 14 _(N) and/or remote clinicians or support staff at the healthcare facility 33 via the ECAS outstations 28 ₁ . . . 28 _(M) and/or an emergency wireless network or a service provider wireless network (e.g., a system analogous to a hospital nurse-call system), when left unattended.

c) Drop Packs 26 ₁ . . . 26 _(R)

The drop packs 26 ₁ . . . 26 _(R) are optional components of the first response support system 10 that can serve to improve the system's coverage and resolution at the incident scene 12, both in terms of location-awareness and physical conditions sensing, irrespective of whether the first responders 14 ₁ . . . 14 _(N) remain at locations where they are dropped. For example, in cases where the first response vehicles 16 ₁ . . . 16 _(M) have to stop some distance away from a “main action area” of the incident scene 12, the first responders 14 ₁ . . . 14 _(N) may place multiple ones of the drop packs 26 ₁ . . . 26 _(R) between the first response vehicles 16 ₁ . . . 16 _(M) and the main action area to allow a concatenated extension of the location-awareness capability out to the main action area. As another example, multiple ones of the drop packs 26 ₁ . . . 26 _(R) can be placed around or near anticipated sources of hazardous conditions such as burning buildings or vehicles, leaking tanks of hazardous or combustible materials, etc. As yet another example, multiple ones of the drop packs 26 ₁ . . . 26 _(R) can also be used to provide more data location data points and physical conditions data points at the incident scene 12 (e.g., additional drop packs may be placed around a burning building before first responders such as firemen enter the building so as to provide very high location coverage through the building's walls to track the locations of these firemen).

FIG. 4 shows an embodiment of a drop pack 26 _(j) of the drop packs 26 ₁ . . . 26 _(R) that is “dropped” (i.e., placed) at any suitable location at the incident scene 12. Other ones of the drop packs 26 ₁ . . . 26 _(R) may be similarly constructed.

The drop pack 26 _(j) comprises suitable hardware and software (which may include firmware) for implementing a plurality of functional components, including, in this embodiment, a location unit 240, an identification unit 246, a sensor unit 248, a wireless interface 242, a user interface 252, a processing entity 250 and a power supply 244. These functional components may be embodied as a single portable device or combination of portable devices carried by a first responder 14 _(i) of the first responders 14 ₁ . . . 14 _(N) at the incident scene 12 until it is dropped by the first responder 14 _(i) at any suitable location at the incident scene 12. For example, the single portable device or combination of portable devices constituting the drop pack 26 _(j) may be arranged as a portable case to be carried by the first responder 14 _(i) until it is dropped at the incident scene 12. A decision to drop the drop pack 26 _(j) at a given location may be made by the first responder 14 _(i) or by the processing system 20 which detects that the first responder 14 _(i) is approaching limits of its active location area and commands the drop pack 26 _(j) to be dropped at that given location. Exact placement of the drop pack 26 _(j) is not required since its location will be determined by the processing system 20. In some cases, one or more other drop packs may be carried by the first responder 14 _(i) in addition to the drop pack 26 _(j) (e.g., inside a single portable housing) and dropped at various locations at the incident scene 12.

The location unit 240 enables the processing system 20 to determine a location of the drop pack 26 _(j). To that end, the location unit 240 comprises a location transmitter (e.g., pinger) 241 to transmit a wireless location signal that allows the processing system 20 to determine the location of the drop pack 26 _(j). For example, the wireless location signal may be a short RF burst or series of short RF bursts. More particularly, in this embodiment, the processing system 20 determines the location of the drop pack 26 _(j) based on three or more times of arrival of the wireless location signal at three of more location receivers having known locations that distributed among some of the ECAS outstations 28 ₁ . . . 28 _(M) and/or other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) using triangulation techniques. In other embodiments, rather than allow the processing system 20 to effect location computations based on times of arrival of the wireless location signal transmitted by the location transmitter 241, the wireless location signal may convey other location data that indicates or can be used to compute the location of the drop pack 26 _(j).

In addition, in this embodiment, once the drop pack 26 _(j) has been located, the location unit 240 enables the processing system 20 to determine locations of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the drop pack 26 _(j). To that end, the location unit 240 comprises a location receiver (e.g., a location sensor) 243 to receive wireless location signals from location transmitters of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the drop pack 26 _(j). As part of the aforementioned cascaded location process (which is further discussed later on), once it has been located by the processing system 20, the drop pack 26 _(j) may transmit a wireless signal to the processing system 20 on a basis of the wireless location signals it receives from these location transmitters in order to allow the processing system 20 to determine locations of those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) from which it received the wireless location signals. As mentioned above, in order to minimize error propagation through the stages of the cascaded location process, the location unit 240 may employ wireless technology allowing a location of those packs within its range to be determined with an excessive level of precision, such as 1 m or better (e.g., 50 cm or even less), to permit a build-up of tolerances in a concatenated location approach to maintain an adequate final level of accuracy. For example, in this embodiment, the location unit 240 may employ UWB technology (e.g., a UWB tag) which offers increased accuracy, down to tens of centimeters or less.

The identification unit 246 provides identification data serving to identify the drop pack 26 _(j). The identification data may comprise one or more identifiers, such as an alphanumeric code (e.g., a UWB tag code, a serial number associated with the drop pack 26 _(j), etc.). The wireless location signal transmitted by the location unit 240 of the drop pack 26 _(j) may comprise the identification data (or data derived therefrom) to allow the processing system 20 to identify the drop pack 26 _(j) it is locating. In this respect, while they are shown as separate components, it will be recognized that in some embodiments functionality of the identification unit 246 and the location unit 240 (and particularly its location transmitter 241) may be implemented by a common component (e.g., a UWB tag).

The sensor unit 248 enables the processing system 20 to understand physical conditions of the incident scene 12 around the drop pack 26 _(j), allowing detection of various inclement, adverse or hazardous conditions surrounding the drop pack 26 _(j), which may improve safety of individuals such as one or more of the first responders 14 ₁ . . . 14 _(N) or patients 18 ₁ . . . 18 _(P) who may be near the pack or heading or expected to head towards it.

More particularly, the sensor unit 248 comprises one or more physical sensors for sensing one or more physical parameters (e.g., temperature, pressure, chemical concentration, electromagnetic radiation level such as light intensity or hard radiation level, vibration level, etc.) and/or other activity (e.g., motion of a person or object) around the drop pack 26 _(j) and for generating data indicative of these one or more physical parameters and/or other physical activity. For example, the sensor unit 248 may comprise one or more of: temperature/heat sensors (e.g., to detect surrounding temperature); pressure sensors (e.g., to detect atmospheric pressure); chemical sensors (e.g., to sense concentrations or traces of chemicals, such as explosive substances); mass/weight sensors (e.g., to sense mass/weight of persons or objects); vibration sensors (e.g., to sense ground vibrations); movement sensors (e.g., to sense movement of persons or objects); sound sensors (e.g., to sense voices, mechanical sounds, sounds from movement); visible light sensors (e.g., to sense visible light intensity) infrared light sensors (e.g., to sense infrared light emitted by persons or objects or effect video surveillance); RF sensors (e.g., to sense RF emissions or interference); hard radiation sensors (e.g., to sense x-rays, gamma rays or other hard radiation to effect Geiger counter/detection of nuclear decay, hidden object sensing); biotoxin sensors (e.g., to sense airborne or surface toxins, bacteria or viruses); cameras (e.g., to detect movement or identify person or objects, for instance, to effect video surveillance or provide imagery of a nearby patient to remote clinicians at the healthcare facility 33); liquid sensors (e.g., to sense presence of water or other liquids); and gas/vapor sensors (e.g., to sense presence of hazardous or harmful gases such as H₂S, CO, methane or propane, and/or hazardous or harmful vapors or gases such as chlorine, fluorine, bromine or petroleum vapors; to sense inadequate levels of oxygen, or presence of smoke or combustion products; etc). These examples are presented for illustrative purposes only as the sensor unit 248 may comprise various sensors with various other sensing capabilities.

The wireless interface 242 provides a bidirectional communication capability to connect the drop pack 26 _(j) to the ECAS outstations 28 ₁ . . . 28 _(M) (e.g., to report location and sensor information). More particularly, the wireless interface 242 comprises a wireless transmitter to transmit wireless signals destined for one or more of the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data generated by the drop pack 26 _(j), such as data derived from a wireless location signal received by its location receiver 243 (e.g., data related to a time of arrival of that signal) and/or data generated by its sensor unit 248. Also, the wireless interface 242 comprises a wireless receiver to receive wireless signals from one or more of the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data destined for the drop pack 26 _(j), such as data indicative of commands to be executed by the drop pack 26 _(j) (e.g., commands to activate/deactivate the location receiver 243 and/or one or more sensors of the sensor unit 248).

The processing entity 250 performs various processing operations to implement functionality of the drop pack 26 _(j). For example, these processing operations may include operations to: process data generated by the sensor unit 248 and data derived from a wireless location signal received by the location receiver 243 (e.g., data related to a time of arrival of that signal); activate/deactivate components of the drop pack 26 _(j) (e.g., the location receiver 243 and/or one or more sensors of the sensor unit 248); cause the wireless interface 242 to transmit a wireless signal conveying data generated by the sensor unit 248 and/or data derived from a wireless location signal received by the location receiver 243 (e.g., data related to a time of arrival of that signal); etc.

The processing operations may also implement a timing and synchronization function to ensure that the location transmitter 241 transmits wireless location signals at precise instants and that times of arrival of wireless locations signals at the location receiver 243 are accurately measured. This measurement may be made based on an absolute timing reference that can be distributed amongst the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS outstations 28 ₁ . . . 28 _(M). Alternatively, the measurement may be made relative to a local timing of the location transmitter 241, in which case a “relative” time of reception at the location receiver 243 of a wireless location signal transmitted by an unlocated one of the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) can be captured and forwarded to the processing system 20. Since it knows the times of reception of wireless location signals transmitted by the location transmitter 241 and has computed the location of that transmitter, the processing system 20 can compute the distance to and hence time of flight from the location receiver 243 and thus can determine, from the measured and reported relative time, the actual time of arrival at the location receiver 243 of the wireless location signal transmitted by the unlocated pack.

The processing entity 250 comprises one or more processors to perform its various processing operations. A given one of these one or more processors may be a general-purpose processor having access to a storage medium (e.g., semiconductor memory, including one or more ROM and/or RAM memory devices) storing program code for execution by that processor to implement the relevant processing operations. Alternatively, a given one of these one or more processors may be a specific-purpose processor comprising one or more pre-programmed hardware or firmware elements (e.g., ASICs, EEPROMs, etc.) or other related elements to implement the relevant processing operations.

The power supply 244 comprises one or more batteries and/or other power storage elements to supply power to the various components of the drop pack 26 _(j). The power supply 244 has a power capacity enabling the drop pack 26 _(j) to be used as long as possible for purposes of the first response mission at the incident scene 12 (e.g., several hours or days or even a few weeks in case of a major disaster). The power supply 244 may also have charging circuitry to facilitate its recharging. The power supply 244 may also provide power by other means. For example, it may comprise powering elements to provide power based on solar or vibrational energy, which can be used to supplement its primary energy source (e.g., to keep powering the location transmitter 241 in cases where the drop pack's main power source has depleted, which can be useful, for instance, in recovering the drop pack once the first response mission is completed).

While in this embodiment the drop pack 26 _(j) comprises various components, in other embodiments, it may not comprise all of these components and/or may comprise different components.

ECAS Outstations 28 ₁ . . . 28 _(M)

The ECAS outstations 28 ₁ . . . 28 _(M) are transported to the incident scene 12 by respective ones of the first response vehicles 16 ₁ . . . 16 _(M) and provide communication, data processing and other functionality between the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS 30 (and other resources within the healthcare facility 33). In particular, in this embodiment, the ECAS outstations 28 ₁ . . . 28 _(M) enable communications between the incident scene 12 and the healthcare facility 33, communications to and from the 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R), reception of wireless location signals to allow nearby ones of these packs to be located and then activated so that their location receivers 43, 143, 243 can contribute to extending the location-awareness area at the incident scene 12, and collection, collation, filtering or other processing of sensor information transmitted by these packs prior to sending this to the ECAS 30 which creates a multi-environmental-plane view of the incident scene 12.

FIG. 5 shows an embodiment of an ECAS outstation 28 _(j) of the ECAS outstations 28 ₁ . . . 28 _(M) that is transported to the incident scene 12 by a vehicle 16 _(j) of the vehicles 16 ₁ . . . 16 _(M). Other ones of the ECAS outstations 28 ₁ . . . 28 _(M) may be similarly constructed.

The ECAS outstation 28 _(j) comprises suitable hardware and software (which may include firmware) for implementing a plurality of functional components, including, in this embodiment, a plurality of pack location units 302 ₁ . . . 302 ₉, an outstation location unit 310, a plurality of sensor units 320 ₁ . . . 320 ₉, a wireless pack interface 330, a wireless ECAS interface 340, a processing entity 360 and a power supply 370. These functional components may be embodied as equipment installed on the vehicle 16 _(j) so as to facilitate their transportation to the incident scene 12.

The pack location units 302 ₁ . . . 302 ₉ are arranged at different positions relative to one another and enable the processing system 20 to determine the locations of individual ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within their range. To that end, each of the pack location units 302 ₁ . . . 302 ₉ comprises a location receiver 303 to receive wireless location signals transmitted by location transmitters 41, 141, 241 of those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within its range. In order to determine the locations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), at least three and preferably more (e.g., four, five or six) location receivers 303 need to “see” the wireless location signals transmitted by these packs. The resolution or precision of the location computation typically depends upon both the distance to the location transmitter 41, 141, 241 of the pack to be located and baseline distances between the location receivers 303 which receive the wireless location signal transmitted by that location transmitter.

More particularly, in this embodiment, the pack location units 302 ₆ . . . 302 ₉ are fixed at known locations on the vehicle 16 _(j). In this case, these locations are non-coplanar to allow location measurements in 3D.

Also, in this embodiment, each of the pack location units 302 ₁ . . . 302 ₅ is disposed on a tip region of a respective one of a plurality of extensible arms (e.g., booms) 307 ₁ . . . 307 ₅ that are capable of being extended relative to a body of the vehicle 16 _(j). The extensible arms 307 ₁ . . . 307 ₄ extend substantially horizontally from respective corner regions of the body of the vehicle 16 _(j) and are dimensioned to give a certain spread (e.g., 20 to 25 ft) about the body of vehicle 16 _(j). This can be done to increase differential path lengths from location receivers to be located and thereby extend a coverage area of sufficient location discrimination by the location receivers 303 of the pack location units 302 ₁ . . . 302 ₄. The extensible arm 307 ₅ extends substantially vertically from a center region of the body of the vehicle 16 _(j) to allow the location receiver 303 of the pack location unit 302 ₅ to be used in determining z-coordinates of those packs from which it receives wireless location signals. The extensible arms 307 ₁ . . . 307 ₅ thus provide longer baseline distances between the location receivers 303 of the pack location units 302 ₁ . . . 302 ₅, thereby providing greater precision and location discrimination out to a greater range.

The locations of the pack location units 302 ₁ . . . 302 ₅ on the extensible arms 307 ₁ . . . 307 ₅ have to be known very accurately if these pack location units are to enable the processing system 20 to accurately determine the locations of those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within their range. This can be achieved in various ways. For example, in this embodiment, each of the pack location units 302 ₁ . . . 302 ₅ comprises a location transmitter (e.g., pinger) 306 to transmit a wireless location signal allowing the processing system 20 to determine a location of that pack location unit. In this case, the processing system 20 determines the location of each of the pack location units 302 ₁ . . . 302 ₅ based on times of arrival of the wireless location signal transmitted by its location transmitter 306 at three or more of the location receivers 303 of the pack location units 302 ₆ . . . 302 ₉ at known locations on the vehicle 16 _(j) using triangulation techniques. In other embodiments, the locations of the pack location units 302 ₁ . . . 302 ₅ may be known to the processing system 20 based on engineering and other information regarding the extensible arms 307 ₁ . . . 307 ₅, such as their actual extension length and orientation, without having to process wireless location signals transmitted by location transmitters such as the location transmitters 306, in which case such location transmitters may be omitted. In yet other embodiments, rather than allow the processing system 20 to effect location computations based on times of arrival of the wireless location signal transmitted by each of the pack location units 302 ₁ . . . 302 ₅, this wireless location signal may convey data that indicates or otherwise allows computation of the location of that pack location unit (e.g., precise angle of arrival of the signal at each receiver or the signal strength at the receiver, based on clear line-of-sight measurements only or a combination of these).

In the aforementioned cascaded location process which is further detailed later on, the pack location units 302 ₁ . . . 302 ₉ receive wireless location signals from those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within their range and, based on data derived from these signals (e.g., data relating to their times of arrival at the location receivers 303), the processing entity 360 of the ECAS outstation 28 _(j) and/or the ECAS 30 (depending on whether local, remote or distributed location computation is used) can compute the location of each of these packs. Once the locations of these packs are determined, the ECAS outstation 28 _(j) can activate the location receivers 43, 143, 243 of these packs and add their measurements to the location computation capability.

As mentioned above, in order to minimize error propagation through the stages of the cascaded location process, the pack location units 302 ₁ . . . 302 ₉ may employ wireless technology allowing a location of those packs within its range to be determined with an excessive level of precision, such as 1 m or better (e.g., 50 cm or even less), to permit a build-up of tolerances in a concatenated location approach to maintain an adequate final level of accuracy. For example, in this embodiment, the pack location units 302 ₁ . . . 302 ₉ may employ UWB technology (e.g., UWB tags) which offers increased accuracy, down to tens of centimeters or less.

The outstation location unit 310 allows a location of the ECAS outstation 28 _(j) to be determined by the processing system 20. This location can be an absolute location or a relative location (relative to an arbitrary site reference), and in some cases may be accompanied by an orientation of the ECAS outstation 28 _(j).

For example, in this embodiment, the outstation location unit 310 may comprise a GPS receiver (with an optional gyroscopic compass) enabling the absolute location (and optionally the orientation) of the ECAS outstation 28 _(j) to be determined based on GPS signaling. As the GPS receiver (e.g., a civilian GPS receiver) may yield approximate results, once the ECAS outstation 28 _(j) has been located, other ones of the ECAS outstations 28 ₁ . . . 28 _(M) may have to locate themselves precisely relative to the ECAS outstation 28 _(j) by means other than GPS so as to establish accurate baselines between the ECAS outstations 28 ₁ . . . 28 _(M) to allow their precise relative location to be determined so that location collaboration between them is possible (as described below) to locate packs in intervening spaces between them or to locate packs far away whereby a long baseline is needed should cascaded location not be available. Also, after a precision location map is built up, this can be used to augment the precision of the absolute location of the ECAS outstation 28 _(j) (e.g., the ECAS outstation 28 _(j) may determine from GPS signaling that its location is within +/−10 meters of 120 meters south of the south wall of 321 Metcalfe Street, but, by measuring the relative location of a drop pack placed at the wall of 321 Metcalfe Street, it may determine that the range to that pack (and hence 321 Metcalfe Street) is 112.3 meters +/−0.7 meters, allowing it to correct its position to being 111.6 to 113 meters south of 321 Metcalfe Street). Furthermore, by using cascaded location capabilities on located ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), combined with an accurate relative location of the ECAS outstations 28 ₁ . . . 28 _(M), if the locations of all these packs is known relative to any ECAS outstation, they may be known relative to all these ECAS outstations. Thus, any one of the first response vehicles 16 ₁ . . . 16 _(M) (except the last one) can leave the incident scene 12 as it is loaded with one or more patients, and the location grid will keep operating since those ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) at known locations can bridge across the gap left and report further locations to the remaining vehicles.

In other embodiments, the outstation location unit 310 may comprise a location receiver and a location transmitter to exchange wireless location signals with other ones of the ECAS outstations 28 ₁ . . . 28 _(M) to allow the absolute or relative location of the ECAS outstation 28 _(j) to be determined on a basis of times of arrival of these signals through collaboration between the ECAS outstations 28 ₁ . . . 28 _(M). In yet other embodiments, relative placement and orientation of the ECAS outstation 28 _(j) can be determined from a reference point (e.g. the first one of the first response vehicles 16 ₁ . . . 16 _(M) on site) by measuring direction and distance to that reference point combined with the orientation of the vehicle 16 _(j) to that reference point (e.g., if the reference point is one of the first response vehicles 16 ₁ . . . 16 _(M), this can be done by use of a high gain/high power version of a UWB location system, which may have a range of up to 1 km or more). In yet other embodiments, the location of the ECAS outstation 28 _(j) can be determined with reference to a city level or site level map or with reference to cellular, WiMax or other wireless location technologies that may be available, possibly with appropriate augmentation similar to that applied to the GPS case above to increase location precision once the location grid is established. Location data indicative of the location of the ECAS outstation 28 _(j) may be transmitted to the ECAS 30 via the wireless ECAS interface 340 and/or used locally by the ECAS outstation 28 _(j) to make location computations.

Each of the sensor units 320 ₁ . . . 320 ₉ enables the processing system 20 to understand physical conditions of the incident scene 12 around the vehicle 16 _(j), allowing detection of various inclement, adverse or hazardous conditions surrounding the vehicle 16 _(j), which may improve safety of individuals such as one or more of the first responders 14 ₁ . . . 14 _(N) or patients 18 ₁ . . . 18 _(P) who may be in or near the vehicle 16 _(j) or heading or expected to head towards it. The sensor units 320 ₁ . . . 320 ₉ may be co-located with the pack location units 302 ₁ . . . 302 ₉ or located at other locations.

More particularly, each of the sensor units 320 ₁ . . . 320 ₉ comprises one or more sensors for sensing one or more physical parameters (e.g., temperature, pressure, chemical concentration, electromagnetic radiation level such as light intensity or hard radiation level, vibration level, etc.) and/or other physical activity (e.g., motion of a person or object) around that sensor unit and generating data indicative of these one or more physical parameters and/or other physical activity. For example, each of the sensor units 320 ₁ . . . 320 ₅ may comprise one or more of: temperature/heat sensors (e.g., to detect surrounding temperature); pressure sensors (e.g., to detect atmospheric pressure); chemical sensors (e.g., to sense concentrations or traces of chemicals, such as explosive substances); mass/weight sensors (e.g., to sense mass/weight of persons or objects); vibration sensors (e.g., to sense ground vibrations); movement sensors (e.g., to sense movement of persons or objects); sound sensors (e.g., to sense voices, mechanical sounds, sounds from movement); visible light sensors (e.g., to sense visible light intensity) infrared light sensors (e.g., to sense infrared light emitted by persons or objects or effect video surveillance); RF sensors (e.g., to sense RF emissions or interference); hard radiation sensors (e.g., to sense x-rays, gamma rays or other hard radiation to effect Geiger counter/detection of nuclear decay, hidden object sensing); biotoxin sensors (e.g., to sense airborne or surface toxins, bacteria or viruses); cameras (e.g., to detect movement or identify person or objects, for instance, to effect video surveillance or provide imagery of a nearby patient to remote clinicians at the healthcare facility 33); liquid sensors (e.g., to sense presence of water or other liquids); and gas/vapor sensors (e.g., to sense presence of hazardous or harmful gases such as H₂S, CO, methane or propane, and/or hazardous or harmful vapors or gases such as chlorine, fluorine, bromine or petroleum vapors; to sense inadequate levels of oxygen, or presence of smoke or combustion products; etc). These examples are presented for illustrative purposes only as each of the sensor units 320 ₁ . . . 320 ₉ may comprise physical sensors with various other sensing capabilities.

The wireless pack interface 330 enables the ECAS outstation 28 _(j) to wirelessly communicate with those packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within its range. To that end, the wireless pack interface 330 comprises a wireless receiver to receive wireless signals transmitted by some of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) and conveying data generated by these packs, such as data derived from wireless location signals received by their location receivers 43, 143, 243, data generated by their sensor units 48, 148, 248, and/or data derived from input made by the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs. In addition, the wireless pack interface 330 comprises a wireless transmitter to transmit wireless signals conveying data destined for some of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), such as data indicative of information to be presented to the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs (e.g., information regarding actions to be performed, such as administering certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility, moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to a different location, etc.) and/or data indicative of commands to be executed by those packs (e.g., commands to activate/deactivate their location receivers 43, 143, 243 and/or one or more sensors of their sensor units 48, 148, 248).

The wireless ECAS interface 340 enables the ECAS outstation 28 _(j) to wirelessly communicate with the ECAS 30 over the wireless communication link 32, which, for instance, may be implemented by a dedicated emergency services link or a publicly available link. More particularly, the wireless ECAS interface 340 comprises a wireless transmitter to transmit to the ECAS 30 wireless signals conveying data for processing at the ECAS 30, such as: data derived from wireless location signals received by the location receivers 43, 143, 243, 303 (e.g., data related to time of arrivals of these signals) to establish locations of some of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P); data generated by the sensor units 48, 148, 248 of these packs and by the sensor units 320 ₁ . . . 320 ₉ of the ECAS outstation 28 _(j); and/or data derived from input made by the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs. The wireless ECAS interface 340 also comprises a wireless receiver to receive wireless signals from the ECAS 30 and conveying data for use locally at the incident scene 12, such as data indicative of information to be presented to some of the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs (e.g., information regarding actions to be performed, such as administering certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility, moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to a different location, etc.) and/or data conveying commands to be executed by some of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) (e.g., commands to activate/deactivate their location receivers 43, 143, 243 and/or one or more sensors of their sensor units 48, 148, 248).

While in this embodiment each of the ECAS outstations 28 ₁ . . . 28 _(M) communicates with the ECAS 30 via the wireless communication link 32, in other embodiments, one or more of these ECAS outstations may communicate with the ECAS 30 via a communication link that is entirely wired or that is partly wired and partly wireless (e.g., established over one or more of a fiber optic metropolitan network or other wired network, a WiMax, cellular or other wireless network, or an emergency band connection).

The processing entity 360 performs various processing operations to implement functionality of the ECAS outstation 28 _(j). These processing operations include operations to cause the wireless ECAS interface 340 to transmit wireless signals to the ECAS 30 based on wireless signals received by the ECAS outstation 28 _(j) from individual ones of packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P). As further discussed below, the ECAS 30 processes data derived from the wireless signals it receives from the ECAS outstation 28 _(j) (possibly in conjunction with data derived from wireless signals it receives from other ones of the ECAS outstations 28 ₁ . . . 28 _(M)) in order to determine one or more actions to be taken with respect to the first response mission.

In this embodiment, the processing entity 360 relays to the ECAS 30 data it derives from wireless signals it receives from the individual ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P). This data may include data derived from wireless location signals received by the location receivers 43, 143, 243, 303 (e.g., data related to time of arrivals of these signals) to establish locations of some of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P); data generated by the sensor units 48, 148, 248 of these packs and by the sensor units 320 ₁ . . . 320 ₉ of the ECAS outstation 28 _(j); and/or data derived from input made by the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs. That is, in this embodiment, the ECAS outstation 28 _(j) acts as a data collection and relay point whereby the processing entity 360 performs relatively simple processing operations to collect data derived from wireless signals transmitted by individual ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), possibly formats the collected data, and relay the collected (and possibly formatted) data to the ECAS 30 where it is more extensively processed. In other embodiments, the processing entity 360 may perform more extensive processing operations. For example, in some embodiments, the processing entity 360 may locally perform location computations based on data related to time of arrivals of wireless location signals at location receivers 43, 143, 243, 303 of individual ones of packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) and the ECAS outstation 28 _(j) to generate location data indicating the locations of these packs and may transmit wireless signals conveying the generated location data to the ECAS 30.

In addition, the processing operations performed by the processing entity 360 include operations to cause the wireless pack interface 330 to transmit wireless signals conveying data destined for individual ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), such as data indicative of information to be presented to first responders via the user interface 52 of these first responder packs and/or data indicative of commands to be executed by these packs, on a basis of wireless signals from the ECAS 30. As further discussed below, such wireless signals received from the ECAS 30 may have been transmitted by the ECAS 30 upon determining one or more actions to be taken with respect to the first response mission.

The processing entity 360 comprises one or more processors to perform its various processing operations. A given one of these one or more processors may be a general-purpose processor having access to a storage medium (e.g., semiconductor memory, including one or more ROM and/or RAM memory devices) storing program code for execution by that processor to implement the relevant processing operations. Alternatively, a given one of these one or more processors may be a specific-purpose processor comprising one or more pre-programmed hardware or firmware elements (e.g., ASICs, EEPROMs, etc.) or other related elements to implement the relevant processing operations.

The power supply 370 comprises one or more batteries and/or other power generation elements to supply power to the various components of the ECAS outstation 28 _(j). The power supply 370 has a power capacity sufficient to enable the ECAS outstation 28 _(j) to be used for purposes of the first response mission at the incident scene 12. The power supply 370 may also have charging circuitry to facilitate its recharging.

While in this embodiment the ECAS outstation 28 _(j) comprises various components, in other embodiments, it may not comprise all of these components and/or may comprise different components.

ECAS 30

FIG. 6 shows an embodiment of the ECAS 30, which, in this embodiment, is located at the healthcare facility 33 remote from the incident scene 12.

The ECAS 30 comprises a processing entity 420 having access to a sensor system 260, a communication system 208 and an institutional information system 200 of the healthcare facility 33 in order to provide various services within the healthcare facility 33. In accordance with an embodiment of the invention, the processing entity 420 of the ECAS 30 also utilizes a wireless outstation interface 400 linked to the ECAS outstations 28 ₁ . . . 28 _(M) at the incident scene 12 via the wireless communication links 32 in order to provide various services in relation to the first response mission at the incident scene 12.

Generally speaking, the ECAS 30 uses location data, physical environment data and communication data derived from the sensor system 260, the communication system 208 and the wireless outstation interface 400 (i.e., from the ECAS outstations 28 ₁ . . . 28 _(M) at the incident scene 12) as well as institutional data from the institutional information system 20 such as policies, guidelines, user lists and profiles, etc., in order to render significant and useful decisions concerning services provided within the healthcare facility 33 or in relation to the first response mission at the incident scene 12. Specifically, the ECAS 30 enables decisions to be made regarding what actions should be taken that are consistent with a particular service, when certain “situations” are deemed to occur, based on data relating to the particular service that is derived from the sensor system 260, the communication system 208 and/or the wireless outstation interface 400.

The decisions taken by the ECAS 30 can result in adaptation or optimization of communications taking place in the communication system 208 and/or involving the first responders 14 ₁ . . . 14 _(N) at the incident scene 12, which may or may not be to such an extent as to enable improved, enhanced or even new clinical workflows and processes to result. This may mean preferentially feeding appropriate information to an authenticated user (including information determined to be relevant to the user's situation), preventing communications to an inappropriate user, adapting communications to the circumstances of the user or the user's equipment, establishing machine-to-machine communication with unattended equipment, initiating communications when certain circumstances arise, and so on.

In this manner, the ECAS 30 can provide adaptive, smart communications, based upon environmental awareness on plural environment-planes (including a location plane and a physical environment plane) and deduced situations, as well as access to permissions and authorization/authentication profiles, policy databases and other institutional information. Thus, services can be provided that adapt to the actual communications needs of users, such as clinicians at the healthcare facility 33 and the first responders 14 ₁ . . . 14 _(N) at the incident scene 12, taking into account both an environment in which they operate and their clinical workflow state.

An understanding of application of an ECAS such as the ECAS 30 to a healthcare facility such as the healthcare facility 33, as well as details regarding services that can be provided within the healthcare facility, can be obtained by consulting U.S. patent application Ser. No. 12/003,206 entitled “METHODS AND SYSTEMS FOR USE IN THE PROVISION OF SERVICES IN AN INSTITUTIONAL SETTING SUCH AS A HEALTHCARE FACILITY”, filed on Dec. 20, 2007 by Graves et al., and hereby incorporated by reference herein.

In accordance with an embodiment of the invention, the ECAS outstations 28 ₁ . . . 28 _(M) in cooperation with the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) enable capabilities of the ECAS 30 to be extended into the first response area at the incident scene 12. This allows the ECAS 30 to provide services relevant to the first response mission at the incident scene 12 (some of which being analogous to services provided within the healthcare facility 33, while others are specific to first response scenarios), thereby optimizing communications involving the first responders 14 ₁ . . . 14 _(N) and increasing first responder effectiveness, quality of care to patients, patient/first responder safety, speed of processing and overall first response site safety.

The aforementioned components of the ECAS 30, as well as examples of services which can be provided by the ECAS 30, will now be discussed in greater detail.

a) Institutional Information System 200

The institutional information system 200 manages institutional information pertaining to the healthcare facility 33. More particularly, in this embodiment, the institutional information system 200 comprises a healthcare information system (HIS) 202, a healthcare clinical information system (HCIS) 204, and a radiology system 206.

The HIS 202 may comprise databases for storing a variety of data, examples of which include general institution data, such as financial data, building maintenance schedules, and so on. The HIS 202 may also comprise databases for storing information about which clinicians (i.e., doctors, nurses, first responders and other medical professionals) are accredited, what their rights and privileges are, their work schedule and preferences (including their IT preferences), etc. The databases in the HIS 202 may also contain information about other healthcare facility support staff, such as orderlies, maintenance staff, administrative staff, or biomedical engineers. The databases in the HIS 202 may also contain information about visiting clinicians who have approval to work in the healthcare facility 33, yet are not formally part of the facility's staff. In that sense, the databases in the HIS 202 can contain information on dynamic/interim users, data, rights and privileges, as well as more formal and more permanent users, data, rights and privileges. The databases in the HIS 202 do not contain clinical information about a patient base of the healthcare facility 33 although they may contain non-clinical data about the patient base.

The HCIS 204 may include: a healthcare clinical information system (HCIS) core, which links and supports clinical databases of multiple departments and databases; departmental systems, many of which may have been acquired as stand-alone functions and may have had to have been subsequently integrated together; local Electronic Health Records (EHRs—or Electronic Patient Records (EPRs)) for patients in the healthcare facility 33 or who have been treated by the healthcare facility 33; test laboratory IT systems and databases with their different functions, modalities and outputs; firewalled secure gateways out to other locations for connectivity to centralized business continuity/disaster recovery (BC/DR), remote centralized EHR, etc.

The HIS 202 and the HCIS 204 may thus comprise databases for storing a variety of data, examples of which include: policies (which define actions to be taken under various situations and for various services in order to achieve desired results); lists of entities (such as doctors, nurses, medical equipment) and associated IDs and AAA information; patient medical status; patient test data; patient schedule data; patient-clinician association data; EHR data; EPR data; EMR data (clinical-based applications); ordered patient treatment data; diagnosis data; prognosis data; staff skills lists; and duty rosters.

These examples of data that may be stored in the HIS 202 and the HCIS 204 are presented for illustrative purposes only as various other data may be stored in these systems. For example, the databases in the HIS 202 and the HCIS 204 may also store policies which describe minimal and optimal combinations of resources (including people, machines, data, network, etc.) to perform certain functions. For instance, the formation of a “Code Blue” team requires certain clinicians and equipment to be reserved within a severely limited time to try and save a patient's life. Other “code names” have their own requirements as well as other processes. It should be appreciated that although the “code names” vary between clinical jurisdictions, a healthcare facility's underlying need for the associated services does not. The names used here are those used as of 2005 in the Doctors Hospital, Columbus, Ohio.

The radiology system 206 comprises a suite of non-visible light imaging modalities, such as X-ray, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, Positron Emission Tomography (PET)-scan as well as a Radiology Information System (RIS) which may include a Picture Archiving and Communication System (PACS) to move imaging data between modalities and diagnostic terminals and radiologists as well as archiving and accessing information stored in a radiology information database.

b) Communication System 208

The communication system 208 provides communication capabilities throughout the healthcare facility 33. For example, this can be achieved by one or more of the following communication networks:

-   -   voice network;     -   data network;     -   converged multimedia network: may use VoIP soft switches to         provide voice services, which in turn provides more opportunity         for communication sessions via SIP;     -   regional and metro networks: many healthcare facilities are         geographically diverse or operate on multiple campuses or have         regional operating entities or fall under common administration.         Thus, there can be an inter-institutional metropolitan network,         which may consist of high-capacity fiber links between         healthcare facilities and data centers, for the purposes of data         storage, PACS and health records systems, disaster recovery,         voice communications, etc. The metropolitan network also allows         the healthcare facilities to communicate with EMS and city         services;     -   video conferencing and telemedicine network: a specialized         infrastructure may exist to support video conferencing and         telemedicine systems requiring higher resolution and/or         time-sensitive performance;     -   wireless network: an example of a wireless local area network         (WLAN) for voice and data point-of care applications.         WLAN-capable user equipment integrate with, for example, nurse         call systems which send informative text to the WLAN-capable         user equipment as the nurse is being called. Other examples         include cell phones or smart phones, which can be used for         scheduling and contact in the WLAN;     -   legacy paging system;     -   equipment monitoring network: some equipment uses legacy 802.11         standards for point-to-point communications (e.g. wireless EKG         monitors). Equipment such as infusion pumps may or may not         contain an 802.11 WLAN communications capability; and     -   clinical and virtual private network (VPN) access: satellite         clinics access the HIS 202 and HCIS 204 via T1, digital         subscriber line (DSL), or VPN. For remote clinicians, such as         outpatient nurses, personal VPN access over the cellular data         network can be used.

These examples of networks which may enable the communication system 208 to provide communication capabilities throughout the healthcare facility 33 are presented for illustrative purposes only as various other networks may be used to provide such communication capabilities.

c) Sensor System 260

The sensor system 260 senses and collects data primitives about various environment planes (including a location plane, a physical environment plane that takes into account heat/temperature, humidity, light, radiation, presence of specific gases or compounds, physical states such as door openings and other physical aspects of the environment, and a physiological plane in respect of patients within the healthcare facility 33) and filters or otherwise pre-processes these data primitives to a point where they can be fed to the processing entity 420.

To that end, the sensor system 260 comprises various sensors distributed throughout the healthcare facility 33 to provide a sensory awareness in multiple environment planes within the healthcare facility 33, such as location and/or movement of people and objects, physical parameters (e.g., temperature, pressure, radiation level, chemical concentrations, etc.) in the healthcare facility 33, physiological parameters (e.g., heart rate, blood pressure, toxin levels) of patients in the healthcare facility 33, etc. For example, the sensor system 260 may comprise one or more of:

-   -   location sensors (with reception and possibly transmission         capabilities): absolute location or relative location (e.g.,         proximity sensors), active and passive;     -   cameras: movement detection and object identification using         picture and video or processed derivations of components         therein;     -   clinical sensors including stand-alone, on-body, in-body         (ingestible or implanted) and on-equipment sensors;     -   sound sensors: voices, mechanical sounds, sounds from movement;     -   vibration sensors: fence vibrations, ground vibrations from         intrude inadvertent interaction;     -   movement sensors: motion sensors, contact openings, closings,         e.g., on gates, doors, entry points;     -   visible light sensors: video surveillance (manual or automatic         analysis), photobeam disruption;     -   infra-red light sensors: video surveillance (manual or automatic         analysis), photobeam disruption, changes in reflected energy,         self-radiation (hot persons, objects);     -   wireless signals: interaction of objects, personnel with RF         fields (quasi-radar or interferometric), active RF emissions         (inadvertent/clandestine or deliberate/IFF);     -   mass/weight/pressure sensors: ground perimeter pressure sensors         for personnel, objects with significant mass, matching mass to         expected mass;     -   chemical sensors: chemical trace analysis, explosives detection;     -   biotoxin sensors: airborne, surface bacteria, virus sensing;     -   hard radiation sensors: Geiger counter/detection of nuclear         decay, hidden object sensing (X-ray, nuclear scanners);     -   liquids/fluids/water sensors: fluid sensors/floats, humidity         sensing; and     -   gas/vapor sensors: hazardous gas detection (e.g., H2S sensor, CO         sensor or sensors for more problematic gases).

These examples of sensors are presented for illustrative purposes only as the sensor system 260 may comprise various other types of sensors to sense various aspects of the healthcare facility 33. Also, some of these or other sensors may be accompanied by complementary actuators (e.g., door position sensors may be accompanied by door lock actuators).

At the incident scene 12, the sensor units and location units of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) and the ECAS outstations 28 ₁ . . . 28 _(M) as well as the processing entities 360 of the ECAS outstations 28 ₁ . . . 28 _(M) can collaborate to implement functionality similar to a distributed version of the functionality of the sensor system 260 of the healthcare facility 33.

d) Wireless Outstation Interface 400

The wireless outstation interface 400 enables the ECAS 30 to wirelessly communicate with the ECAS outstations 28 ₁ . . . 28 _(M) over the wireless communication links 32, either directly or via an interposed network which may be wireless or wired (e.g., a fiber optic metropolitan network or other wired network, a WiMax, cellular or other wireless network, or an emergency band connection).

More particularly, in this embodiment, the wireless outstation interface 400 comprises a wireless receiver to receive wireless signals transmitted by the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data regarding the incident scene 12, such as data derived from wireless location signals received by the location receivers 43, 143, 243, 303 (e.g., data related to time of arrivals of these signals) to establish locations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P); data generated by the sensor units 48, 148, 248 of these packs and by the sensor units 320 ₁ . . . 320 ₉ of the ECAS outstations 28 ₁ . . . 28 _(M); and/or data derived from input made by the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs. The wireless ECAS interface 340 also comprises a wireless transmitter to transmit wireless signals destined for the ECAS outstations 28 ₁ . . . 28 _(M) and conveying data for use at the incident scene 12, such as data indicative of information to be presented to the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs (e.g., information regarding actions to be performed, such as administering certain medical treatment to one or more of the patients 18 ₁ . . . 18 _(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility, moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to a different location, etc.) and/or data conveying commands to be executed by the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) (e.g., commands to activate/deactivate their location receivers 43, 143, 243 and/or one or more sensors of their sensor units 48, 148, 248).

In other embodiments, such as those where the ECAS 30 interfaces to a wired network feeding a local wireless drop to the ECAS outstations 28 ₁ . . . 28 _(M), the wireless outstation interface 400 may be replaced by an equivalent wired network access interface.

e) Processing Entity 420

Through interaction with the sensor system 260, the communication system 208, the wireless outstation interface 400 and the institutional information system 200, the processing entity 420 of the ECAS 30 provides various services within the healthcare facility 33 and, in accordance with an embodiment of the invention, various services in relation to first response missions such as the first response mission at the incident scene 12.

FIG. 7A shows examples of services that can be provided by the ECAS 30 within the healthcare facility 33, including:

-   -   a “clinician tracking” service: tracks the locations of         clinicians, such as doctors, nurses and other clinicians within         the healthcare facility 33;     -   a “patient tracking and/or monitoring” service; tracks the         locations and/or monitors the conditions of patients within the         healthcare facility 33;     -   an “equipment tracking and/or monitoring” service; tracks the         locations and/or monitors the conditions of equipment within the         healthcare facility 33;     -   an “equipment/clinician, equipment/patient or clinician patient         association” service: monitors associations between clinicians,         patients and equipment at the healthcare facility 33;     -   a “clinician point of care communications” service: implements         tools enabling clinicians to access information and perform         clinical tasks (e.g., decisions, treatment orders, etc.) at the         point of care of patients within the healthcare facility 33);     -   a “clinical collaboration” service: implements tools enabling         collaboration between clinicians at the healthcare facility 33;     -   a “code blue/pink—emergency cardiac/respiratory         event—adult/pediatric” service: performs various actions,         including identification and location of the code blue/pink         event and victim and communication to form a code blue/pink team         within the healthcare facility 33;     -   a “code Adam—missing infant or child” service: acts to prevent         abduction or loss of infants within the healthcare facility 33         (e.g., by tracking them) and to find a missing infant when         he/she goes missing (e.g., by issuing alerts);     -   a “code brown—wandering patient protection” service: acts to         prevent wandering of patients within the healthcare facility 33         (e.g., by tracking them) and to find a missing patient when         he/she goes missing (e.g., by issuing alerts);     -   a “code yellow—disaster response” service: performs actions to         prepare the healthcare facility 33 for incoming casualties,         including communications to form the code yellow team, and to         support the code yellow team during initial treatment of         incoming casualties;     -   a “code red—fire” service: detects, assesses and tracks a fire         at the healthcare facility 33 or remote therefrom (e.g., at the         incident scene 12) and issues communications to respond to the         fire (e.g., alerts, areas and directions to evacuate, commands         to close doors, control ventilation, validate via the location         sensing system that all locatable clinicians, staff and patients         are evacuated from evacuation areas, identification of the         location of locatable hazardous or inflammable material relative         to the fire);     -   a “code orange—hazardous material” service: detects, assesses         and tracks hazardous material at the healthcare facility 33 or         remote therefrom (e.g., at the incident scene 12) and issues         communications to respond to the hazardous material (e.g.,         alerts, areas and directions to evacuate, commands to close         doors, control ventilation, validate via the location sensing         system that all locatable clinicians, staff and patients are         evacuated from evacuation areas);     -   a “drug safety, security and environment” service: tracks drugs         within the healthcare facility 33 or remote therefrom (e.g., at         the incident scene 12), manages their inventory and protects         them from being misplaced, stolen or exposed to harmful         environmental conditions; and     -   an “equipment theft or movement outside of authorized         zone—detection” service; detects theft or unauthorized movement         of equipment within the healthcare facility 33 and/or remote         therefrom (e.g., the drop packs 26 ₁ . . . 26 _(R) at the         incident scene 12).

For its part, FIG. 7B shows examples of services that can be provided by the ECAS 30 in support of first response missions such as the first response mission at the incident scene 12, in accordance with an embodiment of the invention. These “first response support” services include:

-   -   a “first responder location and tracking” service: tracks the         locations of the first responders 14 ₁ . . . 14 _(N) at the         incident scene 12;     -   a “patient location and tracking” service: tracks the locations         of the patients 18 ₁ . . . 18 _(P) at the incident scene 12;     -   an “equipment tracking and/or monitoring” service: tracks the         locations and/or monitors the conditions of equipment (e.g.,         field medical equipment and the drop packs 26 ₁ . . . 26 _(R))         at the incident scene 12;     -   a “site environmental sensing” service: collects information         about environmental conditions at the incident scene 12 from the         sensor units 48, 148, 248 of the packs 22 ₁ . . . 22 _(N), 26 ₁         . . . 26 _(R), 24 ₁ . . . 24 _(P) and the sensor units 320 ₁ . .         . 320 ₉ of the ECAS outstations 28 ₁ . . . 28 _(M);     -   a “patient medical sensing” service: collects data about patient         conditions from the medical sensors of the sensor units 148         associated with the patients 18 ₁ . . . 18 _(P) at the incident         scene 12;     -   an “equipment/first responder, equipment/patient or first         responder/patient association” service: monitors associations         between the first responders 14 ₁ . . . 14 _(N), the patients 18         ₁ . . . 18 _(P) and equipment (e.g., the packs 22 ₁ . . . 22         _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)) at the incident         scene 12;     -   a “site environmental sensing association and tracking” service:         observes data from the various sensing planes of the sensor         units 48, 148, 248 of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . .         26 _(R), 24 ₁ . . . 24 _(P) and the sensor units 320 ₁ . . . 320         ₉ of the ECAS outstations 28 ₁ . . . 28 _(M), establishes the         profiles on those planes, and looks for inter-plane associations         that may be indicative of developing site condition issues for         the incident scene 12;     -   a “patient medical sensing association and tracking” service:         correlates and tracks data derived from each patient's medical         sensors (in its sensor unit 148) and identifies potential         conditions needing clinical/first responder notification and/or         treatment;     -   an “immobilized patient tracking and staging” service: tracks at         what stage each patient is at and maps it into required         activities such as a reserved ambulance slot for transportation;     -   a “walking patient” tracking and staging service: tracks where         the patients 18 ₁ . . . 18 _(P) are on site, when they are         mobile and may be wandering about, and maps them into         appropriate transportation away from the incident scene 12         (e.g., via ambulance or otherwise);     -   a “site equipment theft or movement outside of authorized zone”         service: ensures that equipment (e.g., the packs 22 ₁ . . . 22         _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)) at the incident         scene 12 does not “wander” without the first responders 14 ₁ . .         . 14 _(N) being aware of it (e.g., due to legitimate use by         other first responders or by theft by bystanders);     -   a “drugs and similar clinical materials (e.g. blood plasma)         theft, tampering detection plus site inventory tracking         service”: ensures that these are not stolen or tampered with so         are safe to use and can be located when need and ensures that,         if the incident scene 12 starts running short of specific         supplies (e.g., blood plasma) more can be dispatched before they         run out;     -   a “hazardous site conditions detection and response” service:         examines outputs of the site environmental tracking service and         the locations and numbers of patients and first responders and         determines whether action needs to be taken (e.g., evacuate a         specific area of the incident scene 12 first due to         deteriorating conditions in that area);     -   a “drugs and clinical materials environmental safety, security         and application tracking to casualties” service: ensures,         through monitoring with sensors drugs and clinical materials at         the incident scene 12, that these clinical supplies have not         been spoiled by exposure to a harmful environment (e.g., excess         heat) and are being used by approved personnel, and tracks which         patients they are used on so as to provide a “history on demand”         for each patient (e.g., helps to avoid problems such as two         first responders dosing patients with morphine and hence giving         them a morphine overdose);     -   a “first responder point of care/point of stabilization         communications” service: implements tools enabling the first         responders 14 ₁ . . . 14 _(N) to access information and perform         clinical tasks (e.g., decisions, stabilizing treatment and         transportation orders, etc.) at the point of first care of the         patients 18 ₁ . . . 18 _(P) at the incident scene 12;     -   a “first responder/clinician collaboration” service (and its         equivalent “first responder/first responder collaboration”         service): implements tools enabling collaboration between the         first responders 14 ₁ . . . 14 _(N) at the incident site 12 and         clinicians at the healthcare facility 33 (or between different         ones of the first responders 14 ₁ . . . 14 _(N));     -   a “first responder emergency clinical and team support” service:         invoked by a first responder when faced with a patient who is in         a critical declining condition beyond the first responder's         skills or training or when other additional help is needed with         a critical patient, forms a first response team to help from         amongst other ones of the first responders 14 ₁ . . . 14 _(N)         on-site and opens channels to high quality clinical support from         the healthcare facility 33; and     -   a “code yellow—disaster assessment and response and ongoing site         management” service: looks at all clinical activities being         performed by the first responders 14 ₁ . . . 14 _(N) and         situations of the patients 18 ₁ . . . 18 _(P) and provides a         view to the healthcare facility 33 of estimated support         resources needed as the patients 18 ₁ . . . 18 _(P) are         transported as well as helps to optimize deployment of first         response personnel at the incident scene 12; in cases where it         is clear that the first response personnel is overwhelmed, can         trigger additional resources to be called in and, as the first         response personnel complete their work, can release them and can         check (via the patient packs 24 ₁ . . . 24 _(P)) that all         patients needing transportation have been transported).

As shown in FIGS. 7A and 7B, these and other services that can be provided by the ECAS 30 can be categorized into four distinct layers, namely a “basic environmental services” layer 611, an “associative and alerting environmental services” layer 613, a “non-clinical and clinical support services” layer 615, and a “clinical services” layer 617. Each of these service layers can have specific constraints and requirements. For instance, services in the clinical services layer 617 services can be subject to intense scrutiny (e.g., under the Health Insurance Portability and Accountability Act (HIPAA)) to ensure patient information safety and confidentiality is maintained.

In order to provide these services, the processing entity 420 of the ECAS 30 comprises suitable hardware and software (which may include firmware) for implementing a plurality of functional components, which, in this embodiment, include an environmental data processing engine 411, a situational context processing engine 421, an institutional context processing engine 431 and a decision making engine 441. Examples of such processing engines and their functionality, particularly in respect of the services provided in a healthcare facility such as the healthcare facility 33, can be obtained by consulting U.S. patent application Ser. No. 12/003,206 referenced previously herein.

Considering specifically the first response support services contemplated herein, and taking as an example the first response mission at the incident scene 12, the environmental data processing engine 411 processes data transmitted by the ECAS outstations 28 ₁ . . . 28 _(M) and received via the wireless outstation interface 400, such as data related to times of arrival of wireless location signals transmitted by the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), data generated by the sensor units 48, 148, 248 of these packs, data generated by the sensor units 320 ₁ . . . 320 ₉ of these ECAS outstations, and/or data derived from input made by the first responders 14 ₁ . . . 14 _(N) via the user interface 52 of their first responder packs, in order to derive data indicative of an “environment” at the incident scene 12. This environment can be viewed as an aggregation of people, objects, conditions, and influences present at the incident scene 12. It can be observed along a plurality of environment planes, such as a location plane which considers locations of people and objects at the incident scene 12, a physical environment plane which considers heat/temperature, humidity, light, radiation, presence of specific gases or compounds, physical states such as door openings and other physical aspects of the environment at the incident scene 12, and a physiological plane which considers physiological/medical conditions of patients at the incident scene 12. Thus, the data indicative of the environment at the incident scene 12 that is derived by the environmental data processing engine 411 comprises data indicative of various aspects of the environment, such as: locations of the first responders 14 ₁ . . . 14 _(N), the patients 18 ₁ . . . 18 _(P), and the drop packs 26 ₁ . . . 26 _(R) at the incident scene 12; physical parameters such as temperature, pressure, chemical concentration, radiation level, etc., at the incident scene 12; and physiological parameters such as heart rate, body temperature, etc., of the patients 18 ₁ . . . 18 _(P) at the incident scene 12.

The situational context processing engine 421 processes the data indicative of the environment at the incident scene 12 to compare, correlate or otherwise consider different aspects of the environment (e.g., locational, physical, physiological aspects) and determine that one or more “situations” have occurred in relation to the first response mission at the incident scene 12. Each of these one or more situations is a set of circumstances surrounding an event or group of events, a previous history of that event/those events and any associated factors. Collectively, the one or more situations can be viewed as a “situational context” of the first response mission at the incident scene 12.

For example, the situational context processing engine 421 may: compare the locations of the first responders 14 ₁ . . . 14 _(N), the patients 18 ₁ . . . 18 _(P), and the drop packs 26 ₁ . . . 26 _(R) amongst one another (e.g., to detect that a first responder 14 _(i) is next to a patient 18 _(i) and infer from this proximity that the first responder 14 _(i) is treating the patient 18 _(i)); track physical parameters sensed by the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) over time (e.g., to detect a sudden increase in temperature around one of these packs or detect that a hazardous contaminant is spreading in a specific area at the incident scene 12); compare physiological parameters of the patients 18 ₁ . . . 18 _(P) sensed by their packs 24 ₁ . . . 24 _(P) at different times (e.g., to detect a significant drop in vital signs of a patient 18 _(j)); etc.

In determining the one or more situations deemed to have occurred, the situational context processing engine 421 may also process data other than the data indicative of the environment at the incident scene 12. For example, the situational context processing engine 421 may process data derived from the communication system 208 of the healthcare facility 33, such as data relating to communications made the first responders 14 ₁ . . . 14 _(N) using their packs 14 ₁ . . . 14 _(N) (e.g., reports about patients or conditions at the incident scene 12) and/or data relating to communications (e.g., telephonic communications, pages, sessions at computer terminals) involving clinicians at the healthcare facility 33. As another example, the situational context processing engine 421 may process data indicative of an environment at the healthcare facility 33 and derived by the environmental data processing engine 411, such as locations of clinicians and/or equipment within the healthcare facility 33.

Examples of situations that can be deemed to have occurred in relation to the first response mission are presented below. For now, suffice it to say that the situational context processing engine 421 outputs data indicative of the one or more situations deemed to have occurred, i.e., data indicative of the situational context of the first response mission.

The institutional context processing engine 431 consults the institutional information system 200 based on the data indicative of the one or more situations deemed to have occurred in order to provide to the decision making engine 441 institutional data relevant to these one or more situations. The institutional data can be viewed as data indicative of an “institutional context” that specifies, for example, what is allowable (e.g., policies), what resources are available (e.g., people, skills, duty roster, equipment list), what should normally happen (e.g., history) and/or how to proceed (e.g., procedures, rules, guidelines) in respect of the one or more situations. Examples of institutional data that can be provided by the institutional context processing engine 431 are presented below

Based on the data indicative of the one or more situations deemed to have occurred (provided by the situational context processing engine 421) and the institutional data relevant to these one or more situations (provided by the institutional context processing engine 431), the decision making engine 441 determines one or more actions to be taken with respect to the first response mission in order to address these one or more situations. For example, the decision making engine 441 may determine that one or more communication actions are to be taken to address the one or more situations, such as transmitting one or more messages to the first responders 14 ₁ . . . 14 _(N) at the incident scene 12 and/or clinicians at the healthcare facility 33, establishing a communication link between a first responder at the incident scene 12 and a clinician at the healthcare facility 33, etc. The decision making engine 441 can then command the communication system 208 to perform the one or more communication actions that are to be taken (e.g., send commands to the communication system 208 to transmit messages to the first responders 14 ₁ . . . 14 _(N), establish a communication link between a first responder at the incident scene 12 and a clinician at the healthcare facility 33, etc.).

Thus, by virtue of its processing engines 411, 421, 431, the processing entity 420 of the ECAS 30 has both an environmental awareness and a contextual awareness that enables it to make relevant decisions and cause actions to be taken based on these decisions. This can be seen from FIG. 8, which provides a high level view of an “environmental awareness” component 501 and a “contextual awareness and response” component 503 of the processing entity 420 of the ECAS 30.

The environmental awareness component 501, which can be implemented by the environmental data processing engine 411, enables a comprehensive understanding of the environment in which a person or object is, by collecting data from various sensors and other devices (e.g., the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)), bringing this data to a point where data reduction can be applied, whereby it can be logically mapped and correlated and expert system primitives can be derived allowing the detection of various conditions (e.g. proximity of a first responder with his/her assigned patient) and data useful to the situational context processing engine 421 can be formulated. By collecting, aggregating, fusing, and virtualizing this information, a much deeper understanding can be created. This heightened environmental awareness is beneficial on its own merits as an independent functional block for use by other functional blocks and applications. It can also be useful to integrate the result of the environmental awareness component 501 into the contextual awareness and response component 503.

Specifically, the contextual awareness and response component 503 has two parts, namely a situational part 505, which can be implemented by the situational context processing engine 421, and an institutional part 507, which can be implemented by the institutional context processing engine 431. As mentioned above, situational context can be viewed as one or more situations deemed to have occurred in substantially real time, while institutional context can be viewed as the context of what the institution's or facility's policies, procedures and the like would indicate ought to be happening. As a whole, the contextual awareness and response component 503 takes raw information, databases, environmental awareness information and other types of “inputs” and melds this into situationally appropriate awareness and responses. To this end, the contextual awareness and response component 503 may implement contextual fusion (such as synthesis, artificial intelligence, spatial, temporal, multi-dimensional and customized fusion) based on contextual enablers (such as analytics, modeling, personalization, workflow, ontology, identity and inferential engines).

The combination of both environmental awareness (i.e., the environmental data processing engine 411) and contextual awareness and response (i.e., the situational context processing engine 421 and the institutional context processing engine 431), enables a comprehensive understanding of conditions and provides the ability to leverage that understanding to make decisions and take actions by a wide range of workflow and supporting IT systems, applications, and end users or their clients.

The environmental data processing engine 411, the situational context processing engine 421, the institutional context processing engine 431 and the decision making engine 441 may comprise one or more processors to perform their processing operations. A given one of these one or more processors may be a general-purpose processor having access to a storage medium (e.g., semiconductor memory, including one or more ROM and/or RAM memory devices) storing program code for execution by that processor to implement the relevant processing operations. Alternatively, a given one of these one or more processors may be a specific-purpose processor comprising one or more pre-programmed hardware or firmware elements (e.g., ASICs, EEPROMs, etc.) or other related elements to implement the relevant processing operations.

To illustrate how the environmental data processing engine 411, the situational context processing engine 421, the institutional context processing engine 431 and the decision making engine 441 can provide the first response support services contemplated herein, various examples of situations which can arise will now be considered.

Example 1

-   -   By processing the data indicative of the environment at the         incident scene 12 (i.e., location data, physical data,         physiological data) produced by the environmental data         processing engine 411, the situational context processing engine         421 determines that the following situation has occurred: vital         signs of a patient 18 _(x) have dropped significantly (based on         physiological data from the patient pack 24 _(x) of the patient         18 _(x)); none of the first responders 14 ₁ . . . 14 _(N) is         currently treating the patient 18 _(x) (based on their         location); a first responder 14 _(k) who initially treated the         patient 18 _(x) is now far away and treating another patient         (based on their location and/or other determinants of the         situational context, such as communications involving the first         responder 14 _(k) or a state of that other patient's patient         pack); a first responder 14 _(y) is close to the patient 18 _(x)         (based on their location); and the first responder 14 _(y) is         not currently treating any of the patients 18 ₁ . . . 18 _(P)         (based on their location and/or other determinants of the         situational context, such as communications involving the first         responder 14 _(y) or a lack of any current association between         the first responder 14 _(y) and any of the patients).     -   Based on the data indicative of this situation, the         institutional context processing engine 431 consults the         institutional information system 200 to obtain institutional         data relevant to this situation. For instance, the institutional         data may include: data indicating that immediate treatment needs         to be administered to the patient 18 _(x) (based on his/her         vitals signs); data describing the required treatment; and data         defining a skill set of the first responder 14 _(y) (based on         his/her identity).     -   The decision making engine 441 determines, on a basis of the         data indicative of the situation and the institutional data         relevant to the situation, that a message is to be sent to the         first responder 14 _(y) to indicate that the patient 18 _(x)         needs immediate treatment, convey the location of the patient 18         _(x) (and/or directions thereto), and convey information on the         required treatment to be administered. The decision making         engine 441 causes the message to be transmitted to the first         responder pack 22 _(y) of the first responder 14 _(y), via the         communication system 208 and/or the wireless outstation         interface 400.     -   In some cases, depending upon policies of the healthcare         facility 33, a certain level of preference to have the first         responder 14 _(k) who initially treated the patient 18 _(x)         return or notified of actions performed by the first responder         14 _(y) may be invoked for continuity of care reasons (e.g., to         avoid “double dose of morphine” or other problems from         uncoordinated treatments). This may also be managed through a         medical file associated with the patient 18 _(x), which may be         made available to the first responder 14 _(k) or any other         authorized first responder approaching into a proximate         relationship with the patient 18 _(x) after being treated by the         first responder 14 _(y).

Example 2

-   -   By processing the data indicative of the environment at the         incident scene 12 produced by the environmental data processing         engine 411 and by processing data relating to communications         effected via the communication system 208, the situational         context processing engine 421 determines that the following         situation has occurred: a patient 18 _(y) is currently being         treated by a first responder 14 _(z) (based on their location);         and the first responder 14 _(z) has requested treatment         information for the patient 18 _(y) using his/her first         responder pack 22 _(z), for example, by describing a physical         condition or symptoms of the patient 18 _(y) and requesting         assistance from a doctor to determine what treatment to give.     -   Based on the data indicative of this situation, the         institutional context processing engine 431 consults the         institutional information system 200 to obtain institutional         data relevant to this situation. For instance, the institutional         data may include: data indicative that Dr. Smith is available         (based on his schedule and communication status) and qualified         (based on his skill set) to provide assistance to the first         responder 14 _(z).     -   The decision making engine 441 determines, on a basis of the         data indicative of the situation and the institutional data         relevant to the situation, that a message is to be sent to Dr.         Smith to request his assistance and put him in contact with the         first responder 14 _(z) at the incident scene 12 to determine         what treatment to give to the patient 18 _(y). The decision         making engine 441 causes the message to be transmitted to Dr.         Smith via the communication system 208. If and when Dr. Smith is         reached, the decision making engine 441 may cause a         communication link to be established between Dr. Smith and the         first responder 14 _(z) via the communication system 208 and the         first responder pack 22 _(z) of the first responder 14 _(z). In         some cases, this communication link may enable filtered shared         viewing of information concerning the patient 18 _(y) such as         the on-site treatment records to date, vital signs and other         physiological data history or the patient's HER, if available.

Example 3

-   -   By processing the data indicative of the environment at the         incident scene 12 produced by the environmental data processing         engine 411 (and possibly by processing data relating to         communications effected via the communication system 208), the         situational context processing engine 421 determines that the         following situation has occurred: twenty patients 18 ₁ . . . 18         ₂₀ at the incident scene 12 have low vital signs (based on         physiological data from their patient packs 24 ₁ . . . 24 ₂₀ and         possibly based on reports provided by the first responders 14 ₁         . . . 14 _(N) using their first responder packs 22 ₁ . . . 22         _(N)).     -   Based on the data indicative of this situation, the         institutional context processing engine 431 consults the         institutional information system 200 to obtain institutional         data relevant to this situation. For instance, the institutional         data may include: data indicative that seventeen of the patients         24 ₁ . . . 24 ₂₀ need immediate transportation to an ER (based         on their vital signs); data indicative that the ER of the         healthcare facility 33 currently has a capacity to handle a         maximum of ten additional patients (based on the current number         of admitted patients and the available resources, such as         doctors and nurses); and data indicative of another nearby         healthcare facility to which patients may be transported.     -   The decision making engine 441 determines, on a basis of the         data indicative of the situation and the institutional data         relevant to the situation, that messages are to be sent to the         first responders 14 ₁ . . . 14 _(N) to indicate that ten of the         patients 18 ₁ . . . 18 ₂₀ who need immediate transportation are         to be immediately transported to the ER of the healthcare         facility 33 and that the other seven of these patients who need         immediate transportation are to be transported to the other         nearby healthcare facility. The decision making engine 441         causes the messages to be transmitted to the first responder         packs 22 ₁ . . . 22 _(N) of the first responders 14 ₁ . . . 14         _(N), via the communication system 208 and/or the wireless         outstation interface 400.

Example 4

-   -   By processing the data indicative of the environment at the         incident scene 12 produced by the environmental data processing         engine 411, the situational context processing engine 421         determines that the following situation has occurred:         concentration of a toxic gas (e.g., carbon monoxide) has         increased significantly in a particular area at the incident         scene 12 (based on physical data and location data from one or         more of the drop packs 26 ₁ . . . 26 _(R)); a first responder 14         _(x) and a patient 18 _(z) are located in that particular area         (based on their location); no toxic gas has been sensed in other         areas at the incident scene 12 (based on physical data and         location data from one or more of the packs 26 ₁ . . . 26 _(R),         22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P)).     -   Based on the data indicative of this situation, the         institutional context processing engine 431 consults the         institutional information system 200 to obtain institutional         data relevant to this situation. For instance, the institutional         data may include data indicating that immediate evacuation from         the given area is required (based on the concentration of the         toxic gas).     -   The decision making engine 441 determines, on a basis of the         data indicative of the situation and the institutional data         relevant to the situation, that a message is to be sent to the         first responder 14 _(x) to indicate that he/she and the patient         18 _(z) need to immediately move away from their current         location and convey the location of the nearest safe area         (and/or directions thereto). The decision making engine 441         causes the message to be transmitted to the first responder pack         22 _(x) of the first responder 14 _(x), via the communication         system 208 and/or the wireless outstation interface 400.

Example 5

-   -   By processing the data indicative of the environment at the         incident scene 12 produced by the environmental data processing         engine 411, the situational context processing engine 421         determines that the following situation has occurred: hazardous         conditions (e.g., fire, toxic gas, intense structural         vibrations) exist in a given area at the incident scene 12         (based on physical data and location data from one or more of         the packs 26 ₁ . . . 26 _(R), 22 ₁ . . . 22 _(N), 24 ₁ . . . 24         _(P)); two first responders 14 _(y) and 14 _(z) and a patient 18         _(z) they are carrying are moving on a path that passes through         that given area (based on their location and movement         direction); no hazardous conditions have been sensed in other         areas at the incident scene 12 (based on physical data and         location data from one or more of the packs 26 ₁ . . . 26 _(R),         22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P)). In some embodiments,         knowledge of the hazardous conditions in the given area at the         incident scene 12 and of the lack of such hazardous conditions         in the other areas at the incident 12 may be derived from         pre-existing data sources (e.g., sensors, information systems)         available at the incident scene 12 and to which the ECAS         outstations 28 ₁ . . . 28 _(M) may be connected.     -   Based on the data indicative of this situation, the         institutional context processing engine 431 consults the         institutional information system 200 to obtain institutional         data relevant to this situation. For instance, the institutional         data may include data indicating that immediate evacuation from         the given area is required (based on the detected hazardous         conditions).     -   The decision making engine 441 determines, on a basis of the         data indicative of the situation and the institutional data         relevant to the situation, that a message is to be sent to the         first responders 14 _(y) and 14 _(z) to indicate that they are         to take an alternate path and to convey directions describing         this alternate path. The decision making engine 441 causes the         message to be transmitted to the first responder packs 22 _(y)         and 22 _(z) of the first responders 14 _(y) and 14 _(z), via the         communication system 208 and/or the wireless outstation         interface 400.

These examples of situations which can arise and actions that can be taken are presented for illustrative purposes only as various other situations can arise and may be addressed by the ECAS 30.

It will thus be appreciated that the first response support system 10 facilitates the first response mission at the incident scene 12 in that it provides the first responders 14 ₁ . . . 14 _(N) with bidirectional communication capability, real-time support for their information needs, and knowledge about their environment as they stabilize and transport the patients 18 ₁ . . . 18 _(P) under what may be hazardous conditions. By acting on automated decisions based on data on the location and state of the patients 18 ₁ . . . 18 _(P) and the first responders 14 ₁ . . . 14 _(N) and their equipment, the efficiency of first response mission can be improved.

For example:

-   -   Data about the patients 18 ₁ . . . 18 _(P) may be uploaded to         the healthcare facility 33 (and/or one or more other receiving         healthcare facilities) and data to support their treatment and         transportation may be downloaded to the first responder packs 14         ₁ . . . 14 _(N). Vital signs of the patients 18 ₁ . . . 18 _(P)         may be monitored and tracked/analyzed while they are being         prepared for transportation and during transportation.     -   Locations of the first responders 14 ₁ . . . 14 _(N) and the         patients 18 ₁ . . . 18 _(P), as well as evolution of hazardous         conditions at the incident scene 12, may be tracked and alerts         may be sent to the first responders as the environment at the         incident scene 12 changes.     -   Clinical workflows of the first responders 14 ₁ . . . 14 _(N)         can be integrated with workflows of the healthcare facility 33,         allowing its ER (or other receiving department) to prepare for         incoming ones of the patients 18 ₁ . . . 18 _(P). Specifically,         the healthcare facility 33 receives information indicative of         the number, type and condition of the patients 18 ₁ . . . 18         _(P), both from the first responders 14 ₁ . . . 14 _(N) who         provide assessments and/or communicates with clinicians using         their first responder packs 22 ₁ . . . 22 _(N) and from the ECAS         30 which analyzes the ongoing dynamic, monitoring the location,         vital condition, environmental conditions of each patient,         allowing the ECAS 30 to build up a patient record, combine this         with any previous EPR, EMR, EHR, flag issues (e.g. allergies) to         the first responder and the general clinical team and to take         various actions as-needed based on multiple factors including         clinician skills and availability, first responder skills,         availability and proximity to the patient, etc. according to         policies, procedures appropriate to the deemed situation as well         as flag other threats to the patient before or during         transportation.     -   The ECAS 30 can monitor a patient 18 _(j) and, based upon         his/her dynamic patient clinical condition, may instruct actions         to be carried out, such as immediate or more urgent         transportation of the patient 18 _(j), may request activity of a         first responder 14 _(j) on the patient 18 _(j) and/or may         present its findings to a hospital clinician to trigger these         events or may put the clinician in contact with the first         responder 14 _(j), or may forward the patient information to an         appropriate clinician for their determination of a course of         action, based upon hospital policies and procedures.     -   Based upon the collected data, the ECAS 30 can communicate with         an appropriate clinician on a basis of factors such as skills,         availability/current and planned workload, duty roster,         assignment (e.g. to ER), and can establish communications         between the clinician and one or more of the first responders 14         ₁ . . . 14 _(N), especially the first responder who is with or         nearest to a particular patient whose treatment requires         information from the clinician.     -   Assessments of the number, condition, and likely level of         treatment of the patients 18 ₁ . . . 18 _(P) can be made to         route those patients who require further treatment to the         healthcare facility 33 and/or one or more other receiving         healthcare facilities which is/are best suited, allowing load         leveling across the ERs of multiple hospitals and allowing the         entire ER resources of multiple hospitals to be brought to bear         without ending up with too many cases at one ER, while another         one is under-loaded.     -   Verbal assessments about the incident scene 12 made by the first         responders 14 ₁ . . . 14 _(N) may not only be communicated to         personnel at the healthcare facility 33, but may also be         integrated with other data generated by the packs 22 ₁ . . . 22         _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R). For instance, in         some embodiments, the communication system 208 of the healthcare         facility 33 may implement speech processing unit that can parse         a verbal assessment made by a first responder 14 _(j) using the         communication unit 59 of his/her first responder pack 22 _(j) to         identify relevant items of information contained in the first         responder's verbal assessment and provide data conveying this         information to the ECAS 30 (e.g., to the environmental data         processing engine 411 or the situational context processing         engine 421). For example, the first responder 14 _(j) arrives at         the incident scene 12 and realizes that multiple people are         injured. The first responder 14 _(j) can very quickly recognize         and diagnose (at a certain level) various medical related         attributes of an injured person and verbally express his/her         assessment (e.g., “Medical emergency. Victim female, no         identification, Jane Doe, age ˜25-30, second degree burns on         left arm and leg. Possible fractured left leg. Heavy bleeding         above right eye. Collecting pulse and BP from sensor pack”),         which is processed by the speech processing unit that parses the         verbal assessment, identifies relevant items of information         contained therein, assigns meta-tags, and send the resulting         data to the ECAS 30 where it is integrated with all other         appropriate sensor/context information associated with that         person's condition.

While these examples illustrate certain benefits that can be provided by the first response support system 10, it will be appreciated that various other benefits may arise from use of the first response support system 10.

Cascaded Location Process

As mentioned above, in this embodiment, the processing system 20 implements the cascaded location process to extend its location-awareness capability across the incident scene 12. Generally, with the cascaded location process, the processing system 20 determines the locations of the first responder packs 22 ₁ . . . 22 _(N), the drop packs 26 ₁ . . . 26 _(R), and the patient packs 24 ₁ . . . 24 _(P) in multiple stages, whereby located ones of these packs are used to receive wireless location signals from unlocated ones of these packs and transmit wireless signals to the processing system 20 on a basis of the wireless location signals that they receive in order to enable the locations of the unlocated packs to be determined.

The cascaded location process will now be further discussed with reference to FIGS. 9A to 9E, in an example scenario where three vehicles 16 _(x), 16 _(y), 16 _(z) transporting three ECAS outstations 28 _(x), 28 _(y), 28 _(z) arrive at the incident scene 12.

A location of each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) is determined by the ECAS 30 using the outstation location unit 310 of these outstations. More particularly, in this embodiment, the GPS receiver of the outstation location unit 310 of each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) allows each of these outstations to transmit location data indicative of its location to the ECAS 30 via its wireless ECAS interface 340.

Each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) extends its extensible arms 307 ₁ . . . 307 ₅ on which are disposed its pack location units 302 ₁ . . . 302 ₅. Locations of the pack location units 302 ₁ . . . 302 ₅ of each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) are determined by the processing system 20. In this embodiment, the processing system 20 determines the location of each of the pack location units 302 ₁ . . . 302 ₅ of each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) based on times of arrival of a wireless location signal transmitted by its location transmitter 306 at three or more of the location receivers 303 of the pack location units 302 ₆ . . . 302 ₉ (fixed at known locations) of that ECAS outstation (or otherwise, such as based on engineering and other information regarding the extensible arms 307 ₁ . . . 307 ₅, such as their actual extension length and orientation). Once located, the pack location units 302 ₁ . . . 302 ₅ of each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) have their location receivers 303 activated.

The location receivers 303 of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) create respective “primary” coverage areas A1 _(x), A1 _(y), A1 _(z) of these outstations. The primary coverage area A1 _(x) refers to an area in which each point is within the respective ranges of at least three location receivers 303 of the ECAS outstation 28 _(x), thereby allowing a location transmitter in that area to be located through application of triangulation techniques based on a wireless location signal transmitted by that location transmitter and received at these location receivers. The primary coverage areas A1 _(y) and A1 _(z) of the ECAS outstations 28 _(y) and 28 _(z) are similarly defined.

In addition, the location receivers 303 of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) create respective “secondary” coverage areas A2 _(x), A2 _(y), A2 _(z) and respective “tertiary” coverage areas A3 _(x), A3 _(y), A3 _(z) of these outstations. The secondary coverage area A2 _(x) refers to an area in which each point is within the respective ranges of only two location receivers 303 of the ECAS outstation 28 _(x), while the tertiary coverage area A3 _(x) refers to an area in which each point is within the range of only one location receiver 303 of the ECAS outstation 28 _(x). The secondary coverage areas A2 _(y) and A2 _(z) and the tertiary coverage areas A3 _(y) and A3 _(z) of the ECAS outstations 28 _(y) and 28 _(z) are similarly defined. While a location transmitter located in only one of the secondary coverage areas A2 _(x), A2 _(y), A2 _(z) and tertiary coverage areas A3 _(x), A3 _(y), A3 _(z) cannot be located by the processing system 20, a location transmitter located in a region where two or more of these secondary and tertiary coverage areas overlap may be locatable by the processing system 20. In other words, a location transmitter lying outside the primary coverage areas A1 _(x), A1 _(y), A1 _(z) of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) and transmitting a wireless location signal can be located by the processing system 20 when this wireless location signal is received by three or more location receivers 303 distributed among two or all three of the ECAS outstations 28 _(x), 28 _(y), 28 _(z).

While they are shown as circles for simplicity, the coverage areas A1 _(x), A1 _(y), A1 _(z), A2 _(x), A2 _(y), A2 _(z), A3 _(x), A3 _(y), A3 _(z) will typically have more complex configurations depending on the number, relative positions and nature (e.g., omnidirectional or directional, range, etc.) of the location receivers 303 of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) and possibly other factors (e.g., signal path impairments and/or blockages, etc.).

Meanwhile, some of the first responders 14 ₁ . . . 14 _(N) who arrived on the vehicles 16 _(x), 16 _(y), 16 _(z) are deployed, carrying with them some of the first responder packs 22 ₁ . . . 22 _(N) as well as some of the patient packs 24 ₁ . . . 24 _(P) and some of the drop packs 26 ₁ . . . 26 _(R). For purposes of this example, it is assumed that, at a particular moment, these packs, which are denoted 51 ₁ . . . 51 ₁₂ (where each pack 51 _(j) is one of the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R)), are distributed at the incident scene 12 as shown in FIG. 9A.

First Stage

The packs 51 ₁, 51 ₄, 51 ₆, 51 ₉ are located in the primary coverage areas A1 _(x), A1 _(y), A1 _(z) of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) and are thus locatable. For example, the location transmitter 41, 141, 241 of the pack 51 ₁ transmits a wireless location signal L₁ that is received by three or more location receivers 303 of the ECAS outstation 28 _(x). Based on the wireless location signal L₁, the processing system 20 proceeds to determine a location of the pack 51 ₁.

More particularly, in this embodiment, the processing entity 360 of the ECAS outstation 28 _(x) transmits data derived from the wireless location signal L₁ to the ECAS 30 via its wireless ECAS interface 340. In this case, the data derived from the wireless location signal L₁ comprises data relating to times of arrival of that signal at the three or more location receivers 303 of the ECAS outstation 28 _(x). Also, in this case, the data derived from the wireless location signal L₁ comprises identification data conveyed by that signal and provided by the identification unit 46, 146, 246 of the pack 51 ₁.

Upon receiving the data derived from the wireless location signal L₁ via the wireless outstation interface 400, and with knowledge of the location of the ECAS outstation 28 _(x), the processing entity 420 of the ECAS 30 determines the location of the pack 51 ₁ based on this data. More particularly, in this embodiment, the environmental data processing engine 411 implements a location determination unit 432 that determines the location of the pack 51 ₁ based on the data relating to the times of arrival of the wireless location signal L₁ at the three or more location receivers 303 of the ECAS outstation 28 _(x). The location determination unit 432 can employ any suitable triangulation technique (or any other suitable location determination technique or range and direction determination technique).

For example, FIGS. 10A to 10D show an example of a geometry associated with a location determination process based on a differential time of arrival solution. Considering FIG. 10A, this shows a case where three location receivers R1, R2, and R3 (which can be any three location receivers 303 of the ECAS outstation 28 _(x)) receive the wireless location signal L₁ transmitted by the pack 51 ₁ and where the location receivers R1 and R2 have cooperated to determine that R1 received the signal L₁ at time +2 relative to when R2 received the signal L₁. Thus, the time of flight of the signal L₁ to the location receiver R1 is longer by a factor of the time difference multiplied by the propagation velocity, which in this case is the speed of light. The locus or curve of locations which can meet this criterion can be plotted, as shown as “+2 time difference” in FIG. 10A. Other time differences result in other locus curves but the pack 51 ₁ could be located anywhere along that curve. FIG. 10B shows the complete set of locus curves for the location receivers R1 and R2. FIG. 10C overlays the R1-R2 locus curves with the locus curves developed by comparing the time of reception of the signal L₁ at location receivers R3 and R2. While the locus curves are similar in structure to the locus curves of R1 and R2 they are developed around a different baseline, that of R2 to R3, and so do not coincide with the R1-R2 locus curves Hence, by combining these measurements the actual location can be narrowed down to one or sometimes two locations. Repeating this with the third available baseline, R1 to R3, allows the ambiguity to be resolved as is shown in FIG. 10D. As is also shown in these figures, the system becomes less precise at greater distances due to the reduced subtended angle between the source and the receiver baselines. This can be improved by increasing the receiver baselines, either by extending the arms 307 ₁ . . . 307 ₅ of the first response vehicle 16 _(x) or, once the baseline between various vehicles and/or located packs is determined, using those as a long baseline measuring capability. While this example illustrates one type of location determination process, various other location determination processes may be used in other examples

The environmental data processing engine 411 thus obtains data indicative of the location of the pack 51 ₁ from its location determination unit 432. In other embodiments, the location determination unit 432 may be distinct from but connected to the environmental data processing engine 411 to which it may feed the data indicative of the location of the pack 51 ₁ when generated.

In a similar manner, the processing system 20 proceeds to determine a location of each of the packs 51 ₄, 51 ₆, 51 ₉ based on wireless location signals L₄, L₆, L₉ transmitted by these packs and received by three or more location receivers 303 of the ECAS outstation 28 _(y), 28 _(z).

The packs 51 ₅, 51 ₇ are located in a region where the secondary coverage area A2 _(y) of the ECAS outstation 28 _(y) and the tertiary coverage area A3 _(z) of the ECAS outstation 28 _(z) overlap, and are thus also locatable. For example, the location transmitter 41, 141, 241 of the pack 51 ₅ transmits a wireless location signal L₅ that is received by only two location receivers 303 of the ECAS outstation 28 _(y), but that is also received by a single one of the location receivers 303 of the ECAS outstation 28 _(z). Based on the wireless location signal L₅, the processing system 20 proceeds to determine a location of the pack 51 ₅.

More particularly, the processing entity 360 of the ECAS outstation 28 _(y) transmits data derived from the wireless location signal L₅ to the ECAS 30 via its wireless ECAS interface 340, where this data comprises data relating to times of arrival of that signal at the two location receivers 303 of the ECAS outstation 28 _(y) as well as identification data conveyed by that signal and provided by the identification unit 46, 146, 246 of the pack 51 ₅. Similarly, the processing entity 360 of the ECAS outstation 28 _(z) transmits data derived from the wireless location signal L₅ to the ECAS 30 via its wireless ECAS interface 340, where this data comprises data relating to a time of arrival of that signal at the single one of the location receivers 303 of the ECAS outstation 28 _(z) as well as identification data conveyed by that signal and provided by the identification unit 46, 146, 246 of the pack 51 ₅.

Upon receiving the data derived from the wireless location signal L₅ from the ECAS outstations 28 _(y), 28 _(z) via the wireless outstation interface 400, and with knowledge of the location of each of the ECAS outstations 28 _(y), 28 _(z), the processing entity 420 of the ECAS 30 determines the location of the pack 51 ₅ based on this data. More particularly, the location determination unit 432 implemented by the environmental data processing engine 411 determines the location of the pack 51 ₅ based on the data relating to the times of arrival of the wireless location signal L₅ at the two location receivers 303 of the ECAS outstation 28 _(y) and at the single one of the location receivers 303 of the ECAS outstation 28 _(z). The environmental data processing engine 411 thus obtains data indicative of the location of the pack 51 ₅.

In a similar manner, the processing system 20 proceeds to determine a location of the pack 51 ₇ based on a wireless location signal L₇ transmitted by that pack and received by only two location receivers 303 of the ECAS outstation 28 _(y) but also received by a single one of the location receivers 303 of the ECAS outstation 28 _(z).

Second Stage

Having determined the locations of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉, the processing system 20 may use these known locations to determine the locations of other ones of the packs 51 ₁ . . . 51 ₁₂.

Specifically, the ECAS outstation 28 _(x), 28 _(y), 28 _(z) send wireless signals to the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉ conveying commands to activate their location receiver 43, 143, 243 in order to receive wireless location signals from other ones of the packs 51 ₁ . . . 51 ₁₂ that might be within their range. As shown in FIG. 9B, the location receivers 43, 143, 243 of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉ have respective ranges that create respective coverage areas P₁, P₄, P₅, P₆, P₇, P₉, whereby a wireless signal transmitted by a location transmitter within the coverage area P₁ is received by the pack 51 ₁, a wireless signal transmitted by a location transmitter within the pack coverage area P₂ is received by the pack 51 ₂, and so on. While they are shown as circles for simplicity, the coverage areas P₁, P₄, P₅, P₆, P₇, P₉ may have more complex configurations depending on the nature (e.g., omnidirectional or directional, range, etc.) of the location receivers 43, 143, 243 of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉ and possibly other factors (e.g., signal path impairments and/or blockages, etc.).

The coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉ of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉ can be combined with one or more of the secondary coverage areas A2 _(z), A2 _(y), A2 _(z) and tertiary coverage areas A3 _(x), A3 _(y), A3 _(z) of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) in order to locate other ones of the packs 51 ₁ . . . 51 ₁₂. Specifically, a location transmitter located in a region where one or more of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉ and one of the secondary coverage areas A2 _(x), A2 _(y), A2 _(z) overlap or in a region where one or more of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉ and two of the tertiary coverage areas A3 _(x), A3 _(y), A3 _(z) overlap can be located by the processing system 20. Also, depending on distribution of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉, a location transmitter located in a region where three or more of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉ overlap can be located by the processing system 20. In other words, a location transmitter can be located by the processing system 20 when a wireless location signal that it transmits is received by three or more location receivers 303, 43, 143, 243 that are distributed among two or more of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) and the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉.

In this case, the pack 51 ₃ is located in a region where the secondary coverage area A2 _(z) of the ECAS outstation 28 _(z) and the coverage area P₄ of the pack 51 ₄ overlap, the pack 51 ₈ is located in a region where the tertiary coverage area A3 _(z) of the ECAS outstation 28 _(z) and the coverage areas P₆, P₇ of the packs 51 ₆, 51 ₇ overlap, and the pack 51 ₁₁ is located in a region where the secondary coverage area A2 _(y) of the ECAS outstation 28 _(y) and the coverage area P₉ of the pack 51 ₉ overlap. As such, the packs 51 ₃, 51 ₈, 51 ₁₁ are locatable.

For example, the location transmitter 41, 141, 241 of the pack 51 ₃ transmits a wireless location signal L₃ that is received by only two location receivers 303 of the ECAS outstation 28 _(z), but that is also received by the location receiver 43, 143, 243 of the pack 51 ₄. Based on the wireless location signal L₃, the processing system 20 proceeds to determine a location of the pack 51 ₃.

More particularly, the pack 51 ₄ sends a wireless signal S₄ to the ECAS outstation 28 _(z) via its wireless interface 42, 142, 242, in response to receipt of the wireless location signal L₃ by its location receiver 43, 143, 243. The wireless signal S₄ conveys data derived from the wireless location signal L₃, i.e., data conveyed by the signal L₃ and/or data generated upon reception of the signal L₃. In this case, the data conveyed by the wireless signal S₄ comprises data relating to a time of arrival of the signal L₃ at the location receiver 43, 143, 243 of the pack 51 ₄ as well as identification data conveyed by the signal L₃ and provided by the identification unit 46, 146, 246 of the pack 51 ₃. The wireless signal S₄ also conveys the identification data provided by the identification unit 46, 146, 246 of the pack 51 ₄ in order to allow the ECAS outstation 28 _(z) to identify the pack 51 ₄ from which it receives the signal S₄.

The processing entity 360 of the ECAS outstation 28 _(z) transmits data derived from the wireless location signal L₃ to the ECAS 30 via its wireless ECAS interface 340. In this case, the data derived from the wireless location signal L₃ comprises data relating to times of arrival of the signal L₃ at the two location receivers 303 of the ECAS outstation 28 _(z) and at the location receiver 43, 143, 243 of the pack 51 ₄, as well as the identification data conveyed by the signal L₃ and provided by the identification unit 46, 146, 246 of the pack 51 ₃. The processing entity 360 of the ECAS outstation 28 _(z) also transmits to the ECAS 30 via its wireless ECAS interface 340 the identification data conveyed by the wireless signal S₄, which identifies the pack 51 ₄ at which the signal L₃ was also received.

Upon receiving the data derived from the wireless location signal L₃ and the identification data identifying the pack 51 ₄ from the ECAS outstation 28 _(z) via the wireless outstation interface 400, and with knowledge of the location of each of the ECAS outstation 28 _(z) and the pack 51 ₄, the processing entity 420 of the ECAS 30 determines the location of the pack 51 ₃ based on this data. More particularly, the location determination unit 432 implemented by the environmental data processing engine 411 determines the location of the pack 51 ₃ based on the data relating to the times of arrival of the wireless location signal L₃ at the two location receivers 303 of the ECAS outstation 28 _(z) and at the location receiver 43, 143, 243 of the pack 51 ₄. The environmental data processing engine 411 thus obtains data indicative of the location of the pack 51 ₃.

In a similar manner, the processing system 20 proceeds to determine a location of the pack 51 ₁₁ based on a wireless location signal L₁₁ transmitted by that pack and received by only two location receivers 303 of the ECAS outstation 28 _(y) but also received by the location receiver 43, 143, 243 of the pack 51 ₉, which transmits a wireless signal S₉ to the ECAS outstation 28 _(y) in response to receiving the signal L₁₁. Also, the processing system 20 proceeds to determine a location of the pack 51 ₈ based on a wireless location signal L₈ transmitted by that pack and received by only one location receiver 303 of the ECAS outstation 28 _(z) but also received by the location receivers 43, 143, 243 of the packs 51 ₆, 51 ₇, which transmit wireless signals S₆, S₇ to the ECAS outstations 28 _(z), 28 _(y) in response to receiving the signal L₈.

Subsequent Stages

Having determined the locations of the packs 51 ₁, 51 ₃, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₈, 51 ₉, 51 ₁₁, the processing system 20 may use these known locations to determine the locations of remaining ones of the packs 51 ₁ . . . 51 ₁₂.

Specifically, as described above for the second stage, the ECAS outstation 28 _(x), 28 _(y), 28 _(z) send wireless signals to the packs 51 ₃, 51 ₈, 51 ₁₁ conveying commands to activate their location receiver 43, 143, 243 in order to receive wireless location signals from other ones of the packs 51 ₁ . . . 51 ₁₂ that might be within their range. As shown in FIG. 9C, this results in creation of respective coverage areas P₃, P₈, P₁₁ of the packs 51 ₃, 51 ₈, 51 ₁₁, thereby further expanding the overall coverage area. Through overlapping ones of the coverage areas P₁, P₃, P₄, P₅, P₆, P₇, P₈, P₉, P₁₁ of the packs 51 ₁, 51 ₃, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₈, 51 ₉, 51 ₁₁ and the secondary coverage areas A2 _(x), A2 _(y), A2 _(z) and tertiary coverage areas A3 _(x), A3 _(y), A3 _(z) of the ECAS outstations 28 _(x), 28 _(y), 28 _(z), other ones of the packs 51 ₁ . . . 51 ₁₂ can be located by the processing system 20. Indeed, a location transmitter can be located by the processing system 20 when a wireless location signal that it transmits is received by three or more location receivers 303, 43, 143, 243 that are distributed among two or more of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) and the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉, 51 ₁, 51 ₃, 51 ₄, 51 ₅, 51 ₇, 51 ₈, 51 ₉, 51 ₁₁, in a manner similar to that described above for the second stage.

In this case, the pack 51 ₂ is located in a region where the tertiary coverage areas A3 _(x), A3 _(z) of the ECAS outstations 28 _(x), 28 _(z) and the coverage area P₃ of the pack 51 ₃ overlap, and the pack 51 ₁₂ is located in a region where the tertiary coverage area A3 _(y) of the ECAS outstation 28 _(y) and the coverage areas P₁₁, P₇ of the packs 51 ₁₁, 51 ₇ overlap. As such, the packs 51 ₂, 51 ₁₂ are located by the processing system 20 based on wireless locations signals L₂, L₁₂ that they transmit, in a manner similar to that describe above for the second stage.

With the locations of the packs 51 ₂, 51 ₁₂ determined, the ECAS outstation 28 _(x), 28 _(y), 28 _(z) send wireless signals to these packs conveying commands to activate their location receiver 43, 143, 243 in order to receive wireless location signals from other ones of the packs 51 ₁ . . . 51 ₁₂ that might be within their range. As shown in FIG. 9D, this results in creation of respective coverage areas P₂, P₁₂ of the packs 51 ₂, 51 ₁₂, thereby further expanding the overall coverage area.

This latest expansion of the overall coverage area results in the pack 51 ₁₀ being located in a region where the coverage areas P₇, P₈, P₁₂ of the packs 51 ₇, 51 ₈, P₁₂ overlap. As such, the pack 51 ₁₀ is located by the processing system 20 based on a wireless locations signal L₁₀ that it transmits, leading to addition of its coverage area P₁₀ to the overall coverage area, as shown in FIG. 9E.

It will thus be appreciated that, through its multiple stages, the cascade location process enables the processing system 20 to extend its location-awareness capability across the incident scene 12 in an efficient manner by essentially “daisy-chaining” some of the first responder packs 22 ₁ . . . 22 _(N), patient packs 24 ₁ . . . 24 _(P) and drop packs 26 ₁ . . . 26 _(R) that are deployed at the incident scene 12.

In order for the cascaded location process to precisely locate the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), error propagation through the stages of the process should be minimized. To that end, and as mentioned previously, the location units 40, 140, 240 of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P) and the pack location units 302 ₁ . . . 302 ₉ of the ECAS outstations 28 ₁ . . . 28 _(M) may employ wireless technology allowing a location of each of these components to be determined with an excessive level of precision, such as 1 m or less, to permit a build-up of tolerances in a concatenated location approach to maintain an adequate final level of accuracy. For example, in this embodiment, these location units may employ UWB technology (e.g., UWB tags) which offers increased precision, down to tens of centimeters or less. In addition to permitting an expanded range of applications, such as associating a pack with a person near it, or two people together such as one of the first responders 14 ₁ . . . 14 _(N) and one of the patients 18 ₁ . . . 18 _(P), the increased accuracy of UWB technology helps to minimize error propagation through the stages of the cascaded location process.

While each of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P) may normally be located when a wireless location signal that it transmits is received by at least three location receivers 303, 43, 143, 243 that are distributed among two or more of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) and other ones of these packs, it may be useful to use four, five, six or even more location receivers, when possible, to determine the location of a given pack. For example, in some embodiment, a location algorithm implemented by the location determination unit 432 may: determine which location receivers 303, 43, 143, 243 are at known locations, i.e., the “located” location receivers; list all the location transmitters 41, 141, 241 of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P) that can be seen by five, four or three of the located location receivers; compute the locations of those packs that can be seen by the maximum number of located location receivers first, which, in this example, is assumed to be five (in other examples, this may be different depending on the number of location receivers at known locations); and once the locations of those packs is established, their location receivers are turned on, themselves becoming “located” location receivers, and their measurements added to the location computation capability. This is then repeated forming a new list of unlocated location transmitters 41, 141, 241 of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P) that can be seen by five, four or three located location receivers and calculating the location of those unlocated location transmitters which can be seen by the maximum number of located location receivers. In cases where less than five located location receivers can see an unlocated location transmitter, the process can be continued at a level of four located location receivers, still allowing the determination of the location of the unlocated location transmitter in 3D, or even with three located location receivers, although this can allow location in 2D. Starting with five (or more) located location receivers rather than just four or three, may help to counter errors which may otherwise be introduced due to various factors, such as a non-deterministic propagation path associated with the wireless location technology used. For instance, using five located location receivers enables five different 3D computations (Rx_(1,2,3,4), Rx_(1,2,3,5), Rx_(1,2,4,5), Rx_(1,3,4,5) and Rx_(2,3,4,5)) or ten different 2D computations (Rx_(1,2,3), Rx_(1,2,4), Rx_(1,2,5), Rx_(1,3,4), Rx_(1,3,5), Rx_(1,4,5), Rx_(2,3,4), Rx_(2,3,5), Rx_(2,4,5) and Rx_(3,4,5)) to be carried out, allowing detection of potential “outlier” results due to impairments on one path or in one receiver to be detected, whereas using four located location receivers allows a single 3D computation or up to four 2D computations.

With the first responders 14 ₁ . . . 14 _(N) and the patients 18 ₁ . . . 18 _(P) being mobile, in some cases running or otherwise moving very rapidly, the location determination unit 432 implemented by the environmental data processing engine 411 of the ECAS 30 may employ fast-tracking interpolative algorithms to keep track of the locations of the first responder packs 22 ₁ . . . 22 _(N) and the patient packs 24 ₁ . . . 24 _(P). For example, if a first responder 14; is moving at 8 feet per second (˜5 mph), successive location readings on a 250 msec resolution will place him 2 feet from his/her previous location. If 2 feet is larger than an acceptable error for the system, and if his/her first responder pack 22 _(i) is being used to locate other packs, it may be necessary to reduce effects of this error. For instance, if a wireless location signal from a remote pack is received at 102.453 ms after the last wireless location signal transmitted by the pack 22 _(i), then at 8 feet per second the first responder 14 _(i) will have covered 0.811624 ft and so the location computation can take into account that offset.

Although in this embodiment, location computations to determine the locations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) are carried out remotely by the ECAS 30, in other embodiments, such location computations may be performed locally by one or more of the ECAS outstations 28 ₁ . . . 28 _(M). For example, in some embodiments, each of the ECAS outstations 28 ₁ . . . 28 _(M) may effect location computations to determine the locations of those packs that are located inside its primary coverage area A1 and/or that are located in a region where its secondary coverage area A2 or tertiary coverage area A3 overlaps with the coverage area P of one or more packs from which it receives wireless signals. The ECAS outstations 28 ₁ . . . 28 _(M) may then collaborate to exchange the locations of the packs that they have individually determined and to determine the locations of those packs that are located in regions where their secondary and tertiary coverage areas A2, A3 overlap. In other embodiments, one of the ECAS outstations 28 ₁ . . . 28 _(M) may be a “master” outstation to which other ones of these outstations (i.e., “slave” outstations) transmit data derived from wireless signals they receive from packs in order to allow the master outstation to effect the location computations. Location data indicative of the locations of the packs may then be transmitted by each of the ECAS outstations 28 ₁ . . . 28 _(M) or the master outstation, as the case may be, to the ECAS 30.

More generally, while in embodiments considered above the processing system 20 is distributed between locations that are remote from one another (i.e., distributed between the ECAS outstations 28 ₁ . . . 28 _(M) at the incident scene 12 and the ECAS 30 located remotely from the incident scene 12), in other embodiments, the processing system 20 may reside entirely in a single location (i.e., its functionality may be implemented entirely by one of the ECAS outstations 28 ₁ . . . 28 _(M) or the ECAS 30).

Those skilled in the art will appreciate that, in some embodiments, certain functionality of a given component described herein (e.g., the processing entity 50, 150, 250, 360 or 420) may be implemented as pre-programmed hardware or firmware elements (e.g., application specific integrated circuits (ASICs), electrically erasable programmable read-only memories (EEPROMs), etc.) or other related elements. In other embodiments, a given component described herein (e.g., the processing entity 50, 150, 250, 360 or 420) may comprise a general-purpose processor having access to a storage medium that is fixed, tangible, and readable by the general-purpose processor and that stores program code for operation of the general-purpose processor to implement functionality of that given component. The storage medium may store data optically (e.g., an optical disk such as a CD-ROM or a DVD), magnetically (e.g., a hard disk drive, a removable diskette), electrically (e.g., semiconductor memory, including ROM such as EPROM, EEPROM and Flash memory, or RAM), or in any another suitable way. Alternatively, the program code may be stored remotely but transmittable to the given component via a modem or other interface device connected to a network over a transmission medium. The transmission medium may be either a tangible medium (e.g., optical or analog communications lines) or a medium implemented using wireless techniques (e.g., RF, microwave, infrared or other wireless transmission schemes).

Although various embodiments and examples have been presented, this was for the purpose of describing, but not limiting, the invention. Various modifications and enhancements will become apparent to those of ordinary skill in the art and are within the scope of the invention, which is defined by the appended claims. 

1. A system for facilitating a first response mission at an incident scene, said system comprising: a portable patient module to be associated with a patient at the incident scene and configured to transmit wireless signals; and a processing system comprising: at least one receiver to receive the wireless signals; and a processing entity configured to process data derived from the wireless signals and data obtained from an institutional information system of a healthcare facility to determine an action to be performed with respect to the patient.
 2. The system as claimed in claim 1, wherein the wireless signals comprise a wireless signal allowing a location of the patient to be determined, and the data derived from the wireless signals comprises data indicative of the location of the patient.
 3. The system as claimed in claim 1, wherein said portable patient module comprises at least one physiological sensor for sensing at least one physiological parameter of the patient, and the data derived from the wireless signals comprises data indicative of the at least one physiological parameter of the patient.
 4. The system as claimed in claim 3, wherein the at least one physiological parameter of the patient comprises at least one of: a heart rate, a blood pressure; a body temperature; an oxygenation level; a breathing rate; and a toxin level of the patient.
 5. The system as claimed in claim 1, wherein said portable patient module comprises at least one physical sensor for sensing at least one physical parameter or activity at the incident scene, and the data derived from the wireless signals comprises data indicative of the at least one physical parameter or activity.
 6. The system as claimed in claim 5, wherein the at least one sensor comprises at least one of: a temperature/heat sensor; a pressure sensor; a chemical sensor; a mass/weight sensor; a vibration sensor; a movement sensor; a sound sensor; a visible light sensor; an infrared light sensor; an RF sensor; a hard radiation sensor; a toxin sensor; a camera; a liquid sensor; and a gas/vapor sensor.
 7. The system as claimed in claim 1, wherein the action comprises transmission of a message to a first responder at the incident scene, the message conveying information regarding the patient.
 8. The system as claimed in claim 7, wherein the information regarding the patient comprises at least one of: information regarding treatment to be administered to the patient; information regarding transportation of the patient to a healthcare facility; information contained in an electronic healthcare record of the patient; and instructions to move the patient to a different location at the incident scene.
 9. The system as claimed in claim 1, wherein the action comprises establishment of communication between a first responder at the incident scene and a clinician remote from the incident scene to discuss the patient.
 10. The system as claimed in claim 1, wherein the action comprises transmission of a message to initiate preparation of resources at a healthcare facility remote from the incident scene for arrival of the patient.
 11. The system as claimed in claim 1, wherein the action comprises creation of an association between the patient and a first responder at the incident scene.
 12. The system as claimed in claim 1, wherein the data obtained from the institutional information system of the healthcare facility comprises at least one of: a policy; a guideline; a procedure; a lists of entities; a patient medical status; patient test data; patient schedule data; patient-clinician association data; EHR data; EMR data; EPR data; ordered patient treatment data; diagnosis data; prognosis data; a list of staff skills; and a duty roster.
 13. The system as claimed in claim 1, wherein the data obtained from the institutional information system of the healthcare facility comprises information contained in an electronic healthcare record associated with the patient.
 14. A method for facilitating a first response mission at an incident scene, said method comprising: receiving wireless signals transmitted by a portable patient module associated with a patient at the incident scene; and processing data derived from the wireless signals and data obtained from an institutional information system of a healthcare facility to determine an action to be performed with respect to the patient.
 15. The method as claimed in claim 14, wherein the wireless signals comprise a wireless signal allowing a location of the patient to be determined, and the data derived from the wireless signals comprises data indicative of the location of the patient.
 16. The method as claimed in claim 14, wherein the portable patient module comprises at least one physiological sensor for sensing at least one physiological parameter of the patient, and the data derived from the wireless signals comprises data indicative of the at least one physiological parameter of the patient.
 17. The method as claimed in claim 16, wherein the at least one physiological parameter of the patient comprises at least one of: a heart rate, a blood pressure; a body temperature; an oxygenation level; a breathing rate; and a toxin level of the patient.
 18. The method as claimed in claim 14, wherein the portable patient module comprises at least one physical sensor for sensing at least one physical parameter or activity at the incident scene, and the data derived from the wireless signals comprises data indicative of the at least one physical parameter or activity.
 19. The method as claimed in claim 18, wherein the at least one sensor comprises at least one of: a temperature/heat sensor; a pressure sensor; a chemical sensor; a mass/weight sensor; a vibration sensor; a movement sensor; a sound sensor; a visible light sensor; an infrared light sensor; an RF sensor; a hard radiation sensor; a toxin sensor; a camera; a liquid sensor; and a gas/vapor sensor.
 20. The method as claimed in claim 14, wherein the action comprises transmission of a message to a first responder at the incident scene, the message conveying information regarding the patient.
 21. The method as claimed in claim 20, wherein the information regarding the patient comprises at least one of: information regarding treatment to be administered to the patient; information regarding transportation of the patient to a healthcare facility; information contained in an electronic healthcare record of the patient; and instructions to move the patient to a different location at the incident scene.
 22. The method as claimed in claim 14, wherein the action comprises establishment of communication between a first responder at the incident scene and a clinician remote from the incident scene to discuss the patient.
 23. The method as claimed in claim 14, wherein the action comprises transmission of a message to initiate preparation of resources at a healthcare facility remote from the incident scene for arrival of the patient.
 24. The method as claimed in claim 14, wherein the action comprises creation of an association between the patient and a first responder at the incident scene.
 25. The method as claimed in claim 14, wherein the data obtained from the institutional information system of the healthcare facility comprises at least one of: a policy; a guideline; a procedure; a lists of entities; a patient medical status; patient test data; patient schedule data; patient-clinician association data; EHR data; EMR data; EPR data; ordered patient treatment data; diagnosis data; prognosis data; a list of staff skills; and a duty roster.
 26. The method as claimed in claim 14, wherein the data obtained from the institutional information system of the healthcare facility comprises information contained in an electronic healthcare record associated with the patient.
 27. The method as claimed in claim 26, wherein the action comprises transmission of a message to a first responder at the incident scene, the message conveying information regarding medical treatment to be administered to the patient based on the electronic healthcare record associated with the patient.
 28. Computer-readable media containing computer-readable program code executable by a computing apparatus to implement a process for facilitating a first response mission at an incident scene, said computer-readable program code comprising: first program code for causing the computing apparatus to be attentive to receipt of data derived from wireless signals transmitted by a portable patient module associated with a patient at the incident scene; and second program code for causing the computing apparatus to process the data derived from the wireless signals and data obtained from an institutional information system of a healthcare facility to determine an action to be performed with respect to the patient. 